Individual provider Active NPI

Sai Sridhar Reddy Malireddy, M.D

  • Hematology & Oncology Physician
  • Shreveport, LA
National Provider Identifier
1174058358
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
323330 Issued in LA
Practice address
2600 Kings Hwy Ste 340
Shreveport, LA 71103-3951
Phone
(318) 212-8620
Fax
(318) 212-8625
NPI assigned
Apr 26, 2017
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 323330 LA Primary

Addresses

Primary practice location

2600 Kings Hwy Ste 340
Shreveport, LA 71103-3951

Mailing address

2600 Kings Hwy Ste 340
Shreveport, LA 71103-3951
Phone (318) 212-8620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231205000819 LA Practitioner - Internal MedicinePractitioner - Hematology/Oncology 0547534349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology/Oncology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Hematology Oncology AssociatesGroup PAC ID 5597779959, 9 clinicians

Practice addresses (Care Compare)

2600 Kings Hwy
Suite 340
Shreveport, LA 71103-3951
Phone (318) 212-8620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
323330LAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Hematology Oncology Associates Hematology & Oncology CurrentSince Sep 20, 2023 Accepting new patients

Locations

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

2600 Kings Hwy
Ste 340
Shreveport, LA 71103
Phone (318) 212-3702

Organizations & group practices 1

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": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1174058358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 KINGS HWY STE 340",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033951",
            "telephone_number": "318-212-8620",
            "fax_number": "318-212-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 KINGS HWY STE 340",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033951",
            "telephone_number": "318-212-8620",
            "fax_number": "318-212-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIREDDY",
        "first_name": "SAI SRIDHAR REDDY",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "LA",
            "license": "323330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.