Individual provider Active NPI

Sandeepa Shirodkar Rajadhyaksha, M.D.

  • Pediatrics Physician
  • Frisco, TX
National Provider Identifier
1700869393
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M2101 Issued in TX
Practice address
5757 Warren Pkwy Ste 310
Frisco, TX 75034-4287
Phone
(469) 498-6300
Fax
(972) 542-2801
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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 M2101 TX Primary

Addresses

Primary practice location

5757 Warren Pkwy Ste 310
Frisco, TX 75034-4287

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220217001803 TX Practitioner - Pediatric Medicine 1456744333 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M2101TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kids' World Pediatrics, PLLC Pediatrics Current Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Feb 28, 2022 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Feb 28, 2022 Accepting new patients
Topcare Medical Group Inc Past Accepting new patients
Physicians for Children Past Accepting new patients

Locations

2530 Scripture St
Denton, TX 76201
Phone (940) 243-0104

5757 Warren Pkwy
Ste 310
Frisco, TX 75034
Phone (214) 824-2547

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: sandeepa.s.rajadhyaksha.1@14315.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1700869393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 WARREN PKWY STE 310",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344287",
            "telephone_number": "469-498-6300",
            "fax_number": "972-542-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJADHYAKSHA",
        "first_name": "SANDEEPA",
        "middle_name": "SHIRODKAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M2101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.