NPIMap

Individual provider Active NPI

Gautam Bhimidi Reddy, M.D.

  • Interventional Cardiology Physician
  • Plano, TX
National Provider Identifier
1083898365
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
P3064 Issued in TX
Practice address
3801 W 15TH St
BLDG B, Suite 320
Plano, TX 75075-4737
Phone
(972) 985-8838
Fax
(844) 292-1457
NPI assigned
Dec 22, 2007
Last updated
May 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 68545 GA
Interventional Cardiology Physician 207RI0011X 68545 GA
Interventional Cardiology Physician 207RI0011X P3064 TX Primary
Nuclear Cardiology Physician 207UN0901X P3064 TX

Addresses

Primary practice location

3801 W 15TH St
BLDG B, Suite 320
Plano, TX 75075-4737

Mailing address

3801 W 15TH St Ste 320
Plano, TX 75075-7767
Phone (972) 985-8838

Other identifiers 1

IdentifierTypeStateIssuer
334371701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140519000742 TX Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0648427153 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
University of Connecticut School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Heartplace PLLCGroup PAC ID 2769386473, shared by 4 NPIs, 90 clinicians
Cardiac Cath Lab of Collin County, LPGroup PAC ID 2961780382, 7 clinicians

Practice addresses (Care Compare)

1924 Forest Ridge Dr
Suite 400
Bedford, TX 76021-8228
Phone (817) 551-7707

3801 W 15TH St
Suite 320
Plano, TX 75075-7767
Phone (972) 985-8838

5085 W Park Blvd
Suite 180a
Plano, TX 75093-2593
Phone (469) 609-8280

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.32 of 100Reported as individual
Quality
77.33
Promoting interoperability
100
Improvement activities
40
Cost
73.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting14
Varicose vein removal1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
68545GAMDInterventional Cardiology Physician
P3064TXMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartplace, PLLC CurrentSince Apr 1, 2014 Accepting new patients
Legacy Heartcare of Dallas, LLC Cardiovascular Disease CurrentSince Apr 15, 2017 Accepting new patients
Heartplace, PLLC Cardiovascular Disease CurrentSince Apr 1, 2014 Accepting new patients
Legacy Heartcare of Dallas, LLC Cardiovascular Disease CurrentSince Apr 15, 2017 Accepting new patients
Cardiac Cath Lab of Collin County, LP CurrentSince Dec 1, 2016 Accepting new patients
Heartplace, PLLC Cardiovascular Disease Current Accepting new patients
Cardiac Cath Lab of Dallas, LP CurrentSince Sep 1, 2022 Accepting new patients
Heartplace, PLLC CurrentSince Jan 1, 2025 Accepting new patients
Heartplace, PLLC Cardiovascular Disease Past Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

341 Cool Springs Blvd
Ste 305
Franklin, TN 37067
Phone (972) 391-1915

902 W Randol Mill Rd
Ste 200
Arlington, TX 76012
Phone (817) 461-3003

1924 Forest Ridge Dr
Ste 400
Bedford, TX 76021
Phone (817) 551-7707

11970 N Central Expy
Ste 610
Dallas, TX 75243
Phone (469) 232-9393

12230 Coit Rd
Ste 120
Dallas, TX 75251
Phone (972) 490-9500

16980 Dallas Pkwy
Ste 200
Dallas, TX 75248
Phone (214) 343-8565

2500 West Fwy
Ste 200
Ft Worth, TX 76102
Phone (817) 423-4400

7300 Eldorado Pkwy
Ste 105
McKinney, TX 75070
Phone (945) 200-6880

3801 W 15th St
Ste 320
Plano, TX 75075
Phone (972) 596-3201

4716 Dexter Dr
Ste 200
Plano, TX 75093
Phone (817) 502-7027

399 W Campbell Rd
Ste 300
Richardson, TX 75080
Phone (972) 665-9100

Interoperability endpoints

  • Direct secure messaging: gautam.reddy.1@14273.direct.athenahealth.com
  • Direct secure messaging: gautam.reddy@ushv.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/14273/brand/6/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baylor Scott & White the Heart Hospital - PlanoPlano, TX, CCN 670025 Hospital General Partnership Interest Mar 1, 2023
Baylor Scott & White the Heart Hospital - DentonDenton, TX, CCN 450893 Hospital General Partnership Interest Sep 10, 2021
Baylor Scott & White the Heart Hospital RehabilitationDenton, TX, CCN 67T347 Hospital General Partnership Interest Nov 1, 2024
Baylor Scott & White the Heart Hospital - CorinthDenton, TX, CCN 670347 Hospital General Partnership Interest Nov 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1198281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1083898365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 W 15TH ST STE 320",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757767",
            "telephone_number": "972-985-8838",
            "fax_number": "844-292-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 W 15TH ST",
            "address_2": "BLDG B, SUITE 320",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750754737",
            "telephone_number": "972-985-8838",
            "fax_number": "844-292-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "GAUTAM",
        "middle_name": "BHIMIDI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-22",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "68545",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "68545",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "P3064",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "TX",
            "license": "P3064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "334371701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.