Individual provider Active NPI

Nishitha Reddy, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Providence, RI
National Provider Identifier
1194176396
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
MD17821 Issued in RI
Practice address
1085 N Main St
Providence, RI 02904-5719
Phone
(401) 415-4618
Fax
(401) 415-4348
NPI assigned
Jun 29, 2016
Last updated
Oct 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 61758 TN
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X MD17821 RI Primary

Addresses

Primary practice location

1085 N Main St
Providence, RI 02904-5719

Mailing address

1085 N Main St
Providence, RI 02904-5719
Phone (401) 415-4618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20210823000459 RI Practitioner - Hospice/Palliative Care 8729366224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

1085 N Main St
Providence, RI 02904-5719
Phone (401) 415-4275

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

593 Eddy St
Apc 138
Providence, RI 02903-4900
Phone (401) 444-5435

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61758TNMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Sep 13, 2021 Accepting new patients
Hopehealth Hospice & Palliative Care CurrentSince Jul 26, 2021 Accepting new patients
Hopehealth Hospice & Palliative Care CurrentSince Jul 26, 2021 Accepting new patients
Rhode Island Hospital CurrentSince Sep 13, 2021 Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

1085 N Main St
Providence, RI 02904
Phone (401) 415-4200

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
Providence, RI 02903

593 Eddy St
#138
Providence, RI 02903
Phone (401) 444-5291

Organizations & group practices 5

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1194176396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045719",
            "telephone_number": "401-415-4618",
            "fax_number": "401-415-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045719",
            "telephone_number": "401-415-4618",
            "fax_number": "401-415-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "NISHITHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "TN",
            "license": "61758",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "RI",
            "license": "MD17821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.