Sudhakar Reddivalam, M.D.

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

A49339 Issued in CA

Practice address

9300 Valley Childrens PL
Madera, CA 93638-8761

Phone

(559) 353-5550

Fax

(559) 353-5587

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Reddivalam Sudhakar Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sreddivalam15918@valleychildrens-prd.direct-ci.com

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.

• Valley Children's Medical Group

  • Pediatrics Physician
  • Modesto, CA
  • NPI 1437555265
  Medicare reassignment NPD
• Valley Children's Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1952312043
  NPD (past)
• Valley Children's Specialty Medical Group, Inc.

  • Pediatrics Physician
  • Madera, CA
  • NPI 1013968296
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003969429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936388761",
            "telephone_number": "559-353-5550",
            "fax_number": "559-353-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936388761",
            "telephone_number": "559-353-5550",
            "fax_number": "559-353-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDIVALAM",
        "first_name": "SUDHAKAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CA",
            "license": "A49339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL  NUMBER",
            "identifier": "00A493390",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REDDIVALAM",
            "last_name": "SUDHAKAR",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Rayna Piskova M.D., Inc
• Rayna Piskova MD Inc
• Janelle K Raynor, LPCC
• Faisal Saeed Razzaqi, MD
• Cyril William Rebel, MD
• Dana Christine Reed, MPT
• Helena Reed Reed
• Katherine Reed, LCSW
• Reedley Community Hospital (Adventist Health Reedley - Madera Ranchos)
• Jessica Falco Reedy, NP, RN

• Pediatric Pulmonology Physician in Madera, CA
• Providers in Madera, CA by specialty
• Pediatric Pulmonology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.