NPIMap

Organization Active NPI

Reddy Gi Associates

Doing business as AZ Gastro Care

  • Gastroenterology Physician
  • Mesa, AZ
National Provider Identifier
1194957241
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
36640 Issued in AZ
Legal business name
REDDY GI ASSOCIATES
Doing business as
AZ Gastro Care
Practice address
5555 E Baseline Rd
Mesa, AZ 85206-4709
Phone
(480) 393-0575
Fax
(480) 704-4019
NPI assigned
Aug 21, 2009
Last updated
Jun 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Authorized official

Name
Dr. Jae H. Kim, MD
Title
Medical Director
Phone
(480) 393-0575

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 36640 AZ Primary
Surgery Physician 208600000X 36640 AZ

Addresses

Primary practice location

5555 E Baseline Rd
Mesa, AZ 85206-4709

Mailing address

5555 E Baseline Rd
Mesa, AZ 85206-4709
Phone (480) 393-0575

Other practice location 1

604 W Warner Rd Ste D1
Chandler, AZ 85225-2945
Phone (480) 393-0575

Other identifiers 1

IdentifierTypeStateIssuer
194943MedicaidAZ

Other names 1

  • AZ Gastro Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091007000333 AZ Part B Supplier - Clinic/Group Practice 1557407459 Receives reassigned benefits from 22 practitioners
Practice locations: Gilbert, AZ; Queen Creek, AZ; Mesa, AZ; Chandler, AZ; Apache Junction, AZ

National Provider Directory

National Provider Directory

Locations

595 N Dobson Rd
Ste 15
Chandler, AZ 85224

604 W Warner Rd
Bldg D
Chandler, AZ 85225

4001 E Baseline Rd
#102103
Gilbert, AZ 85234

4001 E Baseline Rd
Ste 1021
Gilbert, AZ 85234

604 W Warner Rd Ste D1
Gilbert, AZ 85233

433 E 6th St
Mesa, AZ 85203
Phone (480) 427-3000

6707 N 19th Ave
Ste 200
Phoenix, AZ 85015
Phone (602) 249-4750

37200 N Gantzel Rd
Ste 100
San Tan Valley, AZ 85140
Phone (480) 219-1010

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1194957241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 E BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064709",
            "telephone_number": "480-393-0575",
            "fax_number": "480-704-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 E BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064709",
            "telephone_number": "480-393-0575",
            "fax_number": "480-704-4019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 W Warner Rd Ste D1",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852252945",
            "country_code": "US",
            "telephone_number": "480-393-0575",
            "fax_number": "480-704-4019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REDDY GI ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-21",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JAE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "480-393-0575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "36640",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "36640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194943",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AZ Gastro Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.