Individual provider Active NPI

Kavitha R Reddy, MD

  • Physical Medicine & Rehabilitation Physician
  • Flint, MI
National Provider Identifier
1174515084
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301085040 Issued in MI
Practice address
1311 S Linden Rd Ste a
Flint, MI 48532-3428
Phone
(810) 230-1210
Fax
(810) 230-1225
NPI assigned
Aug 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301085040 MI Primary

Addresses

Primary practice location

1311 S Linden Rd Ste a
Flint, MI 48532-3428

Mailing address

1311 S Linden Rd Ste a
Flint, MI 48532-3428
Phone (810) 230-1210

Other identifiers 8

IdentifierTypeStateIssuer
17429OtherMIM-CARE
4781201MedicaidMI
P00279740OtherMIRAILROAD MEDICARE
0-523-377-0OtherECFMG #
142459OtherMICARE CHOICES-PREFERRED
25050OtherMIBLUE CARE NETWORK
2005005836OtherMOSTATE LICENSE
KR085040OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20051013000691 MI Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain ManagementPractitioner - Pain Management 2264457761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management, Pain Management
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1311 S Linden Rd
Suite a
Flint, MI 48532-3428
Phone (810) 230-1210

Hospital & facility affiliations

  • Achieve Home Health Care Home health agency, Flushing, MI, CCN 239146
  • McLaren Flint Hospital, Flint, MI, CCN 230141
  • McLaren Lapeer Region Hospital, Lapeer, MI, CCN 230193

Merit-based Incentive Payment System (MIPS)

Final score
96.37 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
80.62

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Interventional Pain Management,PLLC CurrentSince Oct 1, 2015 Accepting new patients
Henry Ford Macomb Hospital Corporation Past Accepting new patients

Locations

1311 S Linden Rd
Ste A
Flint, MI 48532
Phone (810) 230-1210

Interoperability endpoints

  • Direct secure messaging: kreddy1148767@direct.hfhs.org

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 3

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1174515084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 S LINDEN RD STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323428",
            "telephone_number": "810-230-1210",
            "fax_number": "810-230-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 S LINDEN RD STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323428",
            "telephone_number": "810-230-1210",
            "fax_number": "810-230-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "KAVITHA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301085040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "17429",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4781201",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00279740",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG #",
            "identifier": "0-523-377-0",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES-PREFERRED",
            "identifier": "142459",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "25050",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2005005836",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "KR085040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.