Individual provider Active NPI

Venugopala A Reddy, MD

  • Internal Medicine Physician
  • Beverly Hills, FL
National Provider Identifier
1194835975
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0042494 Issued in FL
Practice address
3400 N Lecanto Hwy
Suite a
Beverly Hills, FL 34465-3548
Phone
(352) 746-2227
Fax
(352) 746-3587
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0042494 FL Primary

Addresses

Primary practice location

3400 N Lecanto Hwy
Suite a
Beverly Hills, FL 34465-3548

Mailing address

3400 N Lecanto Hwy
Suite a
Beverly Hills, FL 34465-3548
Phone (352) 746-2227

Other identifiers 5

IdentifierTypeStateIssuer
CN2848OtherFLRAILROAD MEDICARE GROUP
07316OtherFLBCBS OF FLORIDA
052196500MedicaidFL
110159321OtherFLRAILROAD MEDICARE PIN
660071900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100721000270 FL Practitioner - Internal Medicine 3072685635 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0042494FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nature Coast Geriatric Services LLC CurrentSince Mar 23, 2015 Accepting new patients

Locations

3404 N Lecanto Hwy
Ste C
Beverly Hills, FL 34465
Phone (352) 746-1558

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1194835975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 N LECANTO HWY",
            "address_2": "SUITE A",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344653548",
            "telephone_number": "352-746-2227",
            "fax_number": "352-746-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 N LECANTO HWY",
            "address_2": "SUITE A",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344653548",
            "telephone_number": "352-746-2227",
            "fax_number": "352-746-3587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "VENUGOPALA",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0042494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CN2848",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "07316",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052196500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "110159321",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660071900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, FL

Sources for this page

Verify at the official NPI Registry.