Individual provider Active NPI

Padma Venuaopala Reddy, MD

  • Nephrology Physician
  • Crystal River, FL
National Provider Identifier
1215029400
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME0053251 Issued in FL
Practice address
7415 W Gulf to Lake Hwy
Crystal River, FL 34429
Phone
(352) 795-1415
Fax
(352) 795-6801
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME0053251 FL Primary

Addresses

Primary practice location

7415 W Gulf to Lake Hwy
Crystal River, FL 34429

Mailing address

7415 W Gulf to Lake Hwy
Crystal River, FL 34429
Phone (352) 795-1415

Other identifiers 3

IdentifierTypeStateIssuer
250407300MedicaidFL
07032OtherBC
063386100MedicaidFL

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
I20101109000540 FL Practitioner - NephrologyPractitioner - Internal Medicine 8022190206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citrus Nephrology Associates Inc 2 clinicians

Practice addresses (Care Compare)

7415 W Gulf to Lake Hwy
Crysal River, FL 34429-7834
Phone (352) 795-1415

Hospital & facility affiliations

  • DaVita Crystal River Dialysis Dialysis facility, Crystal River, FL, CCN 102720
  • Inverness Dialysis Center Dialysis facility, Inverness, FL, CCN 102579
  • Tampa General Hospital Crystal River Hospital, Crystal River, FL, CCN 100249
  • HCA Florida Citrus Hospital Hospital, Inverness, FL, CCN 100023

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0053251FLMDNephrology Physician

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Citrus Nephrology Associates Inc Nephrology CurrentSince Apr 1, 1996 Accepting new patients
Tampa General Hospital Current Accepting new patients

Locations

7415 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 795-1415

330 S Line Ave
Inverness, FL 34452
Phone (352) 444-9868

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: preddy296970@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1215029400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7415 W GULF TO LAKE HWY",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34429",
            "telephone_number": "352-795-1415",
            "fax_number": "352-795-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7415 W GULF TO LAKE HWY",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34429",
            "telephone_number": "352-795-1415",
            "fax_number": "352-795-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PADMA",
        "middle_name": "VENUAOPALA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME0053251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250407300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "07032",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063386100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal River, FL

Sources for this page

Verify at the official NPI Registry.