Individual provider Active NPI

Rekha Selvanaayagam

  • Family Medicine Physician
  • Saugus, MA
National Provider Identifier
1609307909
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
283151 Issued in MA
Practice address
1069 Broadway
Saugus, MA 01906-3210
Phone
(781) 233-1450
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11019389A IN
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 283151 MA Primary

Addresses

Primary practice location

1069 Broadway
Saugus, MA 01906-3210

Mailing address

1069 Broadway
Saugus, MA 01906-3210
Phone (781) 233-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200811001649 MA Practitioner - Family Practice 2365711041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1069 Broadway
Saugus, MA 01906-3210
Phone (781) 233-1450

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11019389AINMDFamily Medicine Physician
283151MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Center, Inc. Current Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Aug 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

1069 Broadway
Saugus, MA 01906
Phone (781) 233-1450

Interoperability endpoints

  • Direct secure messaging: selvanaayagam.rekha.nsmc@direct.partners.masshiway.net

Organizations & group practices 3

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1609307909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 BROADWAY",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019063210",
            "telephone_number": "781-233-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 BROADWAY",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019063210",
            "telephone_number": "781-233-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVANAAYAGAM",
        "first_name": "REKHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11019389A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "283151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saugus, MA

Sources for this page

Verify at the official NPI Registry.