Supraja Reddy Reddy Reddy, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

2014004832 Issued in MO

Practice address

11155 Dunn Rd Ste 109N
Saint Louis, MO 63136-6148

Phone

(314) 953-8799

Fax

(314) 953-8798

NPI assigned

Jul 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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

Specialty

Endocrinology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
• Alton Memorial Hospital Hospital, Alton, IL, CCN 140002
• HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
• St Josephs Hospital Hospital, Breese, IL, CCN 140145

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sreddy10317@direct.carenet.org

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.

• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment Care Compare group NPD
• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1073022000
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760
  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • Ambulance
  • Alton, IL
  • NPI 1063669117

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1548278476
  Care Compare affiliation
• Protestant Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation
• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  • General Acute Care Hospital
  • O Fallon, IL
  • NPI 1629057302
  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  • Rural Health Clinic/Center
  • Breese, IL
  • NPI 1013002658

  Hospital

  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  • General Acute Care Hospital
  • Breese, IL
  • NPI 1457319154
  Care Compare affiliation

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1134432479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11155 DUNN RD STE 109N",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366148",
            "telephone_number": "314-953-8799",
            "fax_number": "314-953-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11155 DUNN RD STE 109N",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366148",
            "telephone_number": "314-953-8799",
            "fax_number": "314-953-8798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2122 Troy Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Edwardsville",
            "state": "IL",
            "postal_code": "620252540",
            "country_code": "US",
            "telephone_number": "618-800-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY REDDY",
        "first_name": "SUPRAJA",
        "middle_name": "REDDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036141805",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2014004832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11155 Dunn Rd Ste 109N",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrice Marcell Reddick, R.N. MAC,CMEC
• Christopher Redding
• Daphne Michele Redding, COTA/L
• Jamie Redding, LCSW
• Lakisha Redditt
• Chandrashekar Reddy, MD MPH
• Chetana M Reddy, MD
• Jyotsna Batapati Krishna Reddy, M.D.
• Katherine Rosemary Reddy, PA
• Kavitha Reddy, M.D.

• Endocrinology, Diabetes & Metabolism Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Endocrinology, Diabetes & Metabolism Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.