Healthcare Provider Details
I. General information
NPI: 1710969050
Provider Name (Legal Business Name): KALA SEETHARAMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/14/2005
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 EATON PL STE 23
WORCESTER MA
01608-1232
US
IV. Provider business mailing address
123 SUMMER ST
WORCESTER MA
01608-1216
US
V. Phone/Fax
- Phone: 508-363-6515
- Fax: 508-363-7515
- Phone: 508-363-5519
- Fax: 508-363-7164
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 76893 |
| License Number State | MA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 04-2472266 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | PRIVATE HEALTHCARE SYSTEM |
| # 2 | |
| Identifier | 042472266 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HEALTHCARE VALUE |
| # 3 | |
| Identifier | 830004120 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | RAILROAD MEDICARE |
| # 4 | |
| Identifier | J16206 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | BLUE SHIELD HMO BLUE |
| # 5 | |
| Identifier | 3000054 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | EVERCARE |
| # 6 | |
| Identifier | J16206 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | BLUE CARE ELECT |
| # 7 | |
| Identifier | 0116799 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | CIGNA HEALTH PLAN |
| # 8 | |
| Identifier | 27052 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HEALTHY START |
| # 9 | |
| Identifier | 5352657 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | AETNA US HEALTHCARE |
| # 10 | |
| Identifier | 04-2472266 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | THREE RIVERS |
| # 11 | |
| Identifier | 1061386 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | FIRST HEALTH |
| # 12 | |
| Identifier | 9901147 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | FALLON COMMUNITY HEALTH |
| # 13 | |
| Identifier | J16206 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | BLUE SHIELD INDEMNITY |
| # 14 | |
| Identifier | 042472266 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | ONE HEALTH PLAN |
| # 15 | |
| Identifier | 27052 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | CHILDRENS MEDICALSECURITY |
| # 16 | |
| Identifier | 784230 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | MVP HEALTH CARE |
| # 17 | |
| Identifier | A20399 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | MEDICARE B |
| # 18 | |
| Identifier | AA2367 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HARVARD PILGRIM HEALTH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
