Organization Active NPI

Vijayalakshmi Reddy MD LLC

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1013122035
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D47644 Issued in MD
Legal business name
VIJAYALAKSHMI REDDY MD LLC
Practice address
821 N Eutaw St
Ste 312
Baltimore, MD 21201-4648
Phone
(410) 225-4455
Fax
(410) 462-5079
NPI assigned
May 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Authorized official

Name
Louise Macy
Title
Billing MGR
Phone
(410) 998-3920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X D47644 MD Primary

Addresses

Primary practice location

821 N Eutaw St
Ste 312
Baltimore, MD 21201-4648

Mailing address

10320 Castlefield St
Ellicott City, MD 21042-5865
Phone (443) 794-6871

Other identifiers 1

IdentifierTypeStateIssuer
124800601MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413001705 MD Part B Supplier - Clinic/Group Practice 1759375512 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D1057313Vijayalakshmi Reddy MD LLC821 N Eutaw Street Suite 303, Baltimore, MD 21201Certificate of waiverAug 7, 2026

National Provider Directory

National Provider Directory

Locations

2600 Liberty Heights Ave
Fl 2
Baltimore, MD 21215
Phone (410) 383-4102

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328140800000",
    "number": "1013122035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10320 CASTLEFIELD ST",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425865",
            "telephone_number": "443-794-6871",
            "fax_number": "410-462-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N EUTAW ST",
            "address_2": "STE 312",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014648",
            "telephone_number": "410-225-4455",
            "fax_number": "410-462-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIJAYALAKSHMI REDDY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-12",
        "last_updated": "2012-02-02",
        "status": "A",
        "authorized_official_last_name": "MACY",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "410-998-3920"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D47644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124800601",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.