Individual provider Active NPI

Sesh Alexander Sundararaman, MD, PHD

  • Pediatric Infectious Diseases Physician
  • Philadelphia, PA
National Provider Identifier
1902335920
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
MD470383 Issued in PA
Practice address
3401 Civic Center Blvd RM 55
Philadelphia, PA 19104-4319
Phone
(215) 590-1220
NPI assigned
Jun 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X MD470383 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd RM 55
Philadelphia, PA 19104-4319

Mailing address

3401 Civic Center Blvd RM 55
Philadelphia, PA 19104-4319
Phone (215) 590-1220

Other practice location 1

3401 Civic Center Blvd Rm 55
Philadelphia, PA 19104-4319
Phone (215) 590-1220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231107002514 PA Practitioner - Infectious Disease 4880041219 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD470383PAMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Pediatric Infectious Diseases CurrentSince Sep 24, 2023 Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Sep 24, 2023 Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Past Accepting new patients

Locations

550 S Goddard Blvd
King of Prussia, PA 19406
Phone (610) 337-3232

3401 Civic Center Blvd
Rm 55
Philadelphia, PA 19104
Phone (215) 510-1220

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3401 Civic Center Blvd
#M975
Philadelphia, PA 19104

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

Organizations & group practices 4

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1902335920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD RM 55",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD RM 55",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd Rm 55",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUNDARARAMAN",
        "first_name": "SESH",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "PA",
            "license": "MD470383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.