NPIMap

Organization Active NPI

Congenial Healthcare, LLC

Doing business as Prathima V Reddy, MD

  • Internal Medicine Physician
  • Wakefield, MA
National Provider Identifier
1033620372
Registry record updated Oct 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CONGENIAL HEALTHCARE, LLC
Doing business as
Prathima V Reddy, MD
Practice address
1 Walton St
Wakefield, MA 01880-1209
Phone
(781) 246-9131
NPI assigned
Oct 13, 2017
Last updated
Oct 13, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
CONGENIAL HEALTHCARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 13, 2017

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

Authorized official

Name
Dr. Prathima V. Reddy, MDNPI 1669447298
Title
Physician
Phone
(781) 246-9131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1 Walton St
Wakefield, MA 01880-1209

Mailing address

1 Walton St
Wakefield, MA 01880-1209
Phone (781) 246-9131

Other names 1

  • Prathima V Reddy, MD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171016002508 MA Part B Supplier - Clinic/Group Practice 5395011522 Receives reassigned benefits from 18 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wakefield, MA; Lynnfield, MA; Peabody, MA; Lynn, MA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Congenial Healthcare LLC7 organizations share this tax ID, including this one
Part of
Congenial Healthcare LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Walton St
Wakefield, MA 01880
Phone (781) 246-9113

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507852800000",
    "number": "1033620372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WALTON ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801209",
            "telephone_number": "781-246-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WALTON ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801209",
            "telephone_number": "781-246-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGENIAL HEALTHCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONGENIAL HEALTHCARE, LLC",
        "enumeration_date": "2017-10-13",
        "last_updated": "2017-10-13",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "PRATHIMA",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "781-246-9131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prathima V Reddy, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wakefield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.