NPIMap

Individual provider Active NPI

Sudesh S Reddy, MD INC

  • Internal Medicine Physician
  • Marion, OH
National Provider Identifier
1104015775
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-053263 Issued in OH
Practice address
402 S State St
Marion
Marion, OH 43302-5000
Phone
(740) 387-0650
NPI assigned
Oct 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-053263 OH Primary
Pediatrics Physician 208000000X 35-053263 OH

Addresses

Primary practice location

402 S State St
Marion
Marion, OH 43302-5000

Mailing address

402 S State St
Marion
Marion, OH 43302-5000
Phone (740) 387-0650

Other identifiers 1

IdentifierTypeStateIssuer
0673114MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20041230000416 OH Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3072571488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 1981
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

402 S State St
Marion, OH 43302-5000
Phone (740) 387-0650

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
26.08 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
86.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy20
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-053263OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sudesh S Reddy MD Inc Internal Medicine CurrentSince Aug 2, 2004 Accepting new patients
Marion General Hospital, Inc. Past Accepting new patients
Gamma Center, Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

402 S State St
Ste A
Marion, OH 43302
Phone (614) 387-0657

402 S State St
Marion, OH 43302
Phone (740) 333-2743

Organizations & group practices 4

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": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1104015775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S STATE ST",
            "address_2": "MARION",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433025000",
            "telephone_number": "740-387-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S STATE ST",
            "address_2": "MARION",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433025000",
            "telephone_number": "740-387-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SUDESH",
        "middle_name": "S",
        "credential": "MD INC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-19",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-053263",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-053263",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0673114",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.