Active NPI
Divya Seetharam Rajan, MD PHD
- Pediatrics Physician
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- P6702
- Practice address
- 1935 Medical District Dr
Dallas, TX 75235-7701 - Phone
- (214) 456-0488
- Fax
- (214) 456-4486
- NPI assigned
- Mar 26, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | P6702 | TX | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | P6702 | TX | Primary |
Addresses
Primary practice location
1935 Medical District Dr
Dallas, TX 75235-7701
Mailing address
1935 Medical District Dr
Dallas, TX 75235-7701
Phone (214) 456-0488
Other names 1
- Divya Seetharam
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190425000697 | TX | Practitioner - Pediatric Medicine | 7517192701 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P6702 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dallas Physician Medical Services for Children Inc | Pediatrics | Current | Accepting new patients |
| Dallas Physician Medical Services for Children Inc | Pediatrics | Current | Accepting new patients |
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| Children'S Health System of Texas | Past | Accepting new patients |
Locations
5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396
1935 Medical District Dr
Unit A
Dallas, TX 75235
1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735
7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300
5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
Interoperability endpoints
- drajan43141@direct.childrens.com
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.
-
- Pediatrics Physician
- Dallas, TX
- NPI 1194153650
Pediatrics, TX
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1942270566
TX
-
- Pediatrics Physician
- Dallas, TX
- NPI 1558407908
Pediatrics
-
- Children's Hospital
- Dallas, TX
- NPI 1194743013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1992029466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1935 MEDICAL DISTRICT DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752357701",
"telephone_number": "214-456-0488",
"fax_number": "214-456-4486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1935 MEDICAL DISTRICT DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752357701",
"telephone_number": "214-456-0488",
"fax_number": "214-456-4486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJAN",
"first_name": "DIVYA",
"middle_name": "SEETHARAM",
"credential": "MD PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-26",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "TX",
"license": "P6702",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "P6702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIVYA",
"last_name": "SEETHARAM",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.