NPIMap

Individual provider Active NPI

Abhinand Venkata Peddada, MD

  • Radiation Oncology Physician
  • Reno, NV
National Provider Identifier
1073504791
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
14810 Issued in NV
Practice address
1155 Mill St
Reno, NV 89502
Phone
(775) 982-4000
Fax
(775) 982-5639
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X A47818 CA
Radiation Oncology Physician 2085R0001X 14810 NV Primary

Addresses

Primary practice location

1155 Mill St
Reno, NV 89502

Mailing address

850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262

Other identifiers 4

IdentifierTypeStateIssuer
00A478180OtherCABLUE SHIELD
1073504791MedicaidNV
10966825OtherCAQH
00A478180MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000844 NV Practitioner - Radiation Oncology 2365420577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Louisiana State University School of Medicine in Shreveport, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4000

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
79.09
Promoting interoperability
100
Improvement activities
40
Cost
71.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A47818CAMDRadiation Oncology Physician
14810NVMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC Radiation Oncology CurrentSince Jul 22, 2013 Accepting new patients
Community Care Services LLC CurrentSince Jul 22, 2013 Accepting new patients
Western Radiation Oncology Inc Radiation Oncology Past Accepting new patients
Community Care Services LLC Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients

Locations

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

850 Harvard Way
Reno, NV 89502

1155 Mill St
Ste L11
Reno, NV 89502

Interoperability endpoints

  • Direct secure messaging: apeddada88191@direct.renown.org

Organizations & group practices 5

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 3

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1073504791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 MILL ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89502",
            "telephone_number": "775-982-4000",
            "fax_number": "775-982-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDADA",
        "first_name": "ABHINAND",
        "middle_name": "VENKATA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A47818",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NV",
            "license": "14810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A478180",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073504791",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10966825",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A478180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.