Individual provider Active NPI

Sreekanthan Sundararaghavan, MBBS, DCH

  • Pediatric Cardiology Physician
  • Lexington, KY
National Provider Identifier
1699657957
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
TP680 Issued in KY
Practice address
740, S Limestone Second Floor Wind D Room L203
Lexington, KY 40536-0001
Phone
(859) 323-6754
Fax
(859) 323-3499
NPI assigned
Jul 25, 2025
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X TP680 KY Primary
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X 35.077143 OH

Addresses

Primary practice location

740, S Limestone Second Floor Wind D Room L203
Lexington, KY 40536-0001

Mailing address

3417 Burch Ave
Cincinnati, OH 45208-2003
Phone (859) 323-6754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20251023004178 KY Practitioner - Pediatric Medicine 7214917301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

115 Waller Ave
Suite 209
Lexington, KY 40503-1035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP680KYMDPediatric Cardiology Physician
35.077143OHMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky Multi-Specialty CurrentSince Oct 15, 2025 Accepting new patients
Kentucky Medical Services Foundation, Inc Multi-Specialty CurrentSince Oct 15, 2025 Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

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": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1699657957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 BURCH AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452082003",
            "telephone_number": "859-323-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740, S LIMESTONE SECOND FLOOR WIND D ROOM L203",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-6754",
            "fax_number": "859-323-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARARAGHAVAN",
        "first_name": "SREEKANTHAN",
        "credential": "MBBS, DCH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "KY",
            "license": "TP680",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OH",
            "license": "35.077143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.