Individual provider Active NPI

Michael Reddy

  • Family Nurse Practitioner
  • Ocala, FL
National Provider Identifier
1104477306
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004877 Issued in FL
Practice address
4600 SW 46TH CT
Ocala, FL 34474-5708
Phone
(352) 291-6583
NPI assigned
Sep 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RN3059232 FL
Family Nurse Practitioner 363LF0000X APRN11004877 FL Primary

Addresses

Primary practice location

4600 SW 46TH CT
Ocala, FL 34474-5708

Mailing address

1539 SE 14TH Ave
Ocala, FL 34471-4530
Phone (352) 895-2329

Other practice location 1

3130 SW 32nd Ave
Ocala, FL 34474-4445
Phone (352) 732-4032

Other identifiers 1

IdentifierTypeStateIssuer
111286900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210225002457 FL Practitioner - Nurse Practitioner 1456766450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocala Oncology Center PLGroup PAC ID 6901950856, 23 clinicians

Practice addresses (Care Compare)

3130 SW 32ND Ave
Ocala, FL 34474-4445
Phone (352) 732-4032

Hospital & facility affiliations

  • Adventhealth Ocala Hospital, Ocala, FL, CCN 100062
  • Marion Communtiy Hospital Hospital, Ocala, FL, CCN 100212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN3059232FLMDFamily Medicine Physician
APRN11004877FLMDFamily Nurse Practitioner

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Ocala Oncology Center PL Family CurrentSince Dec 1, 2020 Accepting new patients
Ocala Oncology Center, PL CurrentSince Dec 1, 2020 Accepting new patients

Locations

13940 N US Highway 441
Ste 203
Lady Lake, FL 32159
Phone (352) 259-8940

3130 SW 32nd Ave
Ocala, FL 34474
Phone (352) 732-4032

9401 SW Highway 200
Ste 702
Ocala, FL 34481
Phone (352) 861-6633

9401 SW Highway 200
Ocala, FL 34481
Phone (352) 401-8660

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1569628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1104477306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 SE 14TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714530",
            "telephone_number": "352-895-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 SW 46TH CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344745708",
            "telephone_number": "352-291-6583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3130 SW 32nd Ave",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344744445",
            "country_code": "US",
            "telephone_number": "352-732-4032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-28",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "RN3059232",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111286900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.