Individual provider Active NPI

Rathidevi Subramani

  • Dentist
  • Batavia, IL
National Provider Identifier
1669736088
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019029085 Issued in IL
Practice address
853 N Randall Rd
Batavia, IL 60510-1992
Phone
(630) 879-2222
NPI assigned
Jun 29, 2012
Last updated
Feb 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019029085 IL Primary

Addresses

Primary practice location

853 N Randall Rd
Batavia, IL 60510-1992

Mailing address

866 Oak Ridge Blvd
Elgin, IL 60120-9219
Phone (847) 739-6272

Other names 1

  • Dr. Rathidevi Subramani Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160404001424 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7113224213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019029085ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Design 32 Dental P.C. Dentist CurrentSince Apr 14, 2024 Accepting new patients
Pacer Dental P.C. Past Accepting new patients

Locations

1336 N Route 59
Ste 100
Naperville, IL 60563
Phone (847) 890-2186

Organizations & group practices 2

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1669736088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "866 OAK RIDGE BLVD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601209219",
            "telephone_number": "847-739-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 N RANDALL RD",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101992",
            "telephone_number": "630-879-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBRAMANI",
        "first_name": "RATHIDEVI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RATHIDEVI",
            "last_name": "SUBRAMANI",
            "prefix": "DR.",
            "credential": "D.D.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Batavia, IL

Sources for this page

Verify at the official NPI Registry.