Individual provider Active NPI

Mitta Ananth Reddy, MD

  • Anesthesiology Physician
  • Glasgow, KY
National Provider Identifier
1063443356
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
19502 Issued in KY
Practice address
1301 N Race St
Glasgow, KY 42141-3483
Phone
(270) 651-4444
Fax
(270) 651-4229
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 19502 KY Primary

Addresses

Primary practice location

1301 N Race St
Glasgow, KY 42141-3483

Mailing address

1301 N Race St
Glasgow, KY 42141-3483
Phone (270) 651-4444

Other identifiers 3

IdentifierTypeStateIssuer
64195027MedicaidKY
P00119850OtherKYRAILROAD MCARE
000000052139OtherKYANTHEM

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20091230000292 KY Practitioner - Anesthesiology 3375581663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
T J Samson Community HospitalGroup PAC ID 0648182600, 197 clinicians

Practice addresses (Care Compare)

1301 N Race St
Glasgow, KY 42141-3454
Phone (270) 651-4430

Hospital & facility affiliations

  • T J Samson Community Hospital Hospital, Glasgow, KY, CCN 180017

Merit-based Incentive Payment System (MIPS)

Final score
86.3 of 100Reported as group
Quality
74.59
Promoting interoperability
100
Improvement activities
40
Cost
68.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
T J Samson Community Hospital Current Accepting new patients
T J Samson Community Hospital Current Accepting new patients
T J Samson Community Hospital CurrentSince Jul 2, 2021 Accepting new patients

Locations

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1063443356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413483",
            "telephone_number": "270-651-4444",
            "fax_number": "270-651-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413483",
            "telephone_number": "270-651-4444",
            "fax_number": "270-651-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MITTA",
        "middle_name": "ANANTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "19502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64195027",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE",
            "identifier": "P00119850",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000052139",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.