Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1578720439 Individual Practitioner Male Practitioner

Dr. Shesha Kalyan Katakam , MD, MPH

Pediatrics • Ferguson, MO

Professional Overview & Biography Verified Profile Summary

Dr. Shesha Katakam, MD, MPH is a registered healthcare professional specializing in Pediatrics in Ferguson, MO. Practice services are available at 3878 PERSHALL RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3878 Pershall Rd

Ferguson, MO 631351246

Telephone 3148397500
Associated Practice Facility / Clinic
🏢 Rainbow Pediatrics Inc. Facility NPI 1578745170

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Ferguson, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.4 Yrs
Regional Practice Density
4 Specialists

Practicing in Ferguson, MO (1616 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-01-20
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License IN 01073004A

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License LA MD.202228

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
201188170 (IN)
Commercial Insurance / Payer ID Anthem Bcbs
000000833441 (IN)
Commercial Insurance / Payer ID Medicare Ptan
151020017 (IN)

Secondary Practice Locations

1509 State St

La Porte, IN 463503115

Phone: 2193243431

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1033199062

Doctor of Medicine (M.D.)

NPI 1073947495

Doctor of Medicine (M.D.)

NPI 1770870776

Doctor of Medicine (M.D.)

Jahmille Simon , PPCNP-BC

Nurse Practitioner - Pediatrics

NPI 1841792926

PPCNPBC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location January 20, 2023

Registered at 3878 PERSHALL RD, FERGUSON, MO 631351246 (Tel: 3148397500)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 16, 2020

Pediatrics (License #MD.202228 in LA)

📍
Updated Business Mailing Address August 13, 2020

Registered at 1509 STATE ST, LA PORTE, IN 463503115 (Tel: 2193243431)

NPI Profile Active December 09, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location December 09, 2014

Registered at 1509 STATE ST, LA PORTE, IN 463503115 (Tel: 2193243431)

📍
Updated Business Mailing Address December 09, 2014

Registered at PO BOX 1690, LA PORTE, IN 463521690 (Tel: 2193262312)

👤
Provider Name / Credentials Updated December 09, 2014

Recorded as SHESHA KATAKAM, MD, MPH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 09, 2014

Pediatrics (License #01073004A in IN)

🟢
Initial NPI Registration & Enumeration May 19, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1578720439
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 19, 2008
Last Update: January 20, 2023
Sole Proprietor: No

Mailing Address

1509 State St

La Porte, IN 463503115

Phone: 2193243431

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.