Shruti Reddy Kommareddy, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

SC006523 Issued in PA

Practice address

3900 Woodland Ave
Philadelphia, PA 19104-4551

Phone

(215) 823-5800

NPI assigned

Sep 10, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1225463284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044551",
            "telephone_number": "215-823-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMMAREDDY",
        "first_name": "SHRUTI",
        "middle_name": "REDDY",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006523",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC006523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sirisha Komakula
• Lydia T Komarnicky, MD
• Jack Komejan, L.C.S.W.
• Orna Komisar, MD
• Jessica Komisor
• Kommunison Behavioral Support LLC
• Gregoris Komodikis, MB BS
• Christopher W. Komurek, D.O.
• Elena Konakova
• Salimata Konate

• Foot Surgery Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Foot Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.