Individual provider Active NPI

Sarada M Reddy, MD

  • Radiation Oncology Physician
  • Tampa, FL
National Provider Identifier
1104826056
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
199428 Issued in NY
Practice address
15416 N Florida Ave
Tampa, FL 33613-1244
Phone
(813) 960-2400
Fax
(813) 960-2410
NPI assigned
Jul 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 199428 NY Primary

Addresses

Primary practice location

15416 N Florida Ave
Tampa, FL 33613-1244

Mailing address

15416 N Florida Ave
Tampa, FL 33613-1244
Phone (813) 960-2400

Other identifiers 1

IdentifierTypeStateIssuer
01662931MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040930000227 NY Practitioner - Radiation Oncology 7517861677 Reassigns benefits to 2 organizations
I20210216001371 FL Practitioner - Radiation Oncology 7517861677 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
199428NYMDRadiation Oncology Physician
119336NYMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bernard F Germain, MD PA CurrentSince Dec 14, 2020 Accepting new patients
St Marys Healthcare CurrentSince Apr 26, 2016 Accepting new patients
St. Mary'S Healthcare CurrentSince Apr 26, 2016 Accepting new patients
St. Mary'S Healthcare Past Accepting new patients
Upstate Urology Past Accepting new patients

Locations

4197 Woodlands Pkwy
Palm Harbor, FL 34685
Phone (727) 786-3810

15416 N Florida Ave
Tampa, FL 33613
Phone (813) 497-7757

380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415

4950 State Highway 30
Amsterdam, NY 12010
Phone (518) 770-7557

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1104826056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15416 N FLORIDA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131244",
            "telephone_number": "813-960-2400",
            "fax_number": "813-960-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15416 N FLORIDA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131244",
            "telephone_number": "813-960-2400",
            "fax_number": "813-960-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SARADA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "199428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01662931",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.