Individual provider Active NPI

Radhika Sadagopan, M.D.

  • Pediatrics Physician
  • Cary, NC
National Provider Identifier
1578564571
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2006-01825 Issued in NC
Practice address
3434,Kildaire Farm Road
Suite 124
Cary, NC 27518-2277
Phone
(919) 362-7155
Fax
(919) 362-7153
NPI assigned
Aug 2, 2005
Last updated
May 20, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2006-01825 NC Primary

Addresses

Primary practice location

3434,Kildaire Farm Road
Suite 124
Cary, NC 27518-2277

Mailing address

113 Hatchet Creek CT
Morrisville, NC 27560-9514
Phone (919) 342-6683

Other identifiers 1

IdentifierTypeStateIssuer
5907258MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241029000960 NC Practitioner - Pediatric Medicine 0840262747 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-01825NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tots N Teens Pediatrics PLLC Pediatrics CurrentSince Jun 17, 2024 Accepting new patients

Locations

3434 Kildaire Farm Rd
Ste 124
Cary, NC 27518
Phone (919) 362-7155

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1578564571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HATCHET CREEK CT",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275609514",
            "telephone_number": "919-342-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434,KILDAIRE FARM ROAD",
            "address_2": "SUITE 124",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275182277",
            "telephone_number": "919-362-7155",
            "fax_number": "919-362-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADAGOPAN",
        "first_name": "RADHIKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2006-01825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907258",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.