Individual provider Active NPI

Deepti Seshadri, M.D.

  • Surgery Physician
  • Brockton, MA
National Provider Identifier
1821249566
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
125054830 Issued in IL
Practice address
680 Centre St
Brockton, MA 02302-3308
Phone
(508) 894-0400
Fax
(508) 894-0564
NPI assigned
Sep 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125054830 IL Primary

Addresses

Primary practice location

680 Centre St
Brockton, MA 02302-3308

Mailing address

680 Centre St
Brockton, MA 02302-3308
Phone (508) 894-0400

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
I20141212001280 MA Practitioner - Colorectal Surgery (Proctology) 3072745900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Jefferson Medical College of Thomas Jefferson University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Hospital & facility affiliations

  • Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
70.13
Promoting interoperability
100
Improvement activities
40
Cost
75.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125054830ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Hospital, Inc. CurrentSince Oct 6, 2014 Accepting new patients
Signature Healthcare Medical Group Inc Surgery CurrentSince Oct 6, 2014 Accepting new patients
Brockton Hospital, Inc. CurrentSince Oct 6, 2014 Accepting new patients

Locations

110 Liberty St
Ste 2A
Brockton, MA 02301
Phone (508) 894-0766

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

Interoperability endpoints

  • Direct secure messaging: deepti.seshadri@direct.signature.masshiway.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Signature Healthcare Brockton HospitalBrockton, MA, CCN 22S052 Hospital Corporate Director Jan 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 1

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": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1821249566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESHADRI",
        "first_name": "DEEPTI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125054830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.