Individual provider Active NPI

Pavanaja Reddy, M.D.

  • Anesthesiology Physician
  • Lakeland, FL
National Provider Identifier
1235135989
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME141843 Issued in FL
Practice address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone
(863) 680-7000
Fax
(866) 264-8519
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 206427 NY
Anesthesiology Physician 207L00000X ME141843 FL Primary

Addresses

Primary practice location

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone (863) 680-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050407000094 NY Practitioner - Anesthesiology 7416904842 Reassigns benefits to 4 organizations
I20200727002959 FL Practitioner - Anesthesiology 7416904842 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians

Practice addresses (Care Compare)

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as apm
Quality
70.68
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME141843FLMDAnesthesiology Physician
206427NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates MD PA Anesthesiology CurrentSince Jul 6, 2020 Accepting new patients
Sunshine State Anesthesia Partners LLC Anesthesiology CurrentSince Feb 28, 2021 Accepting new patients
Great South Bay Endoscopy Center, LLC CurrentSince Nov 25, 2019 Accepting new patients
Lynbrook Anesthesia Services, PC Anesthesiology CurrentSince Jan 1, 2020 Accepting new patients
Queens Endoscopy ASC, LLC CurrentSince Nov 13, 2019 Accepting new patients
Watson Clinic LLP CurrentSince Jul 18, 2022 Accepting new patients
Gastrointestinal Care of Long Island PLLC CurrentSince Oct 1, 2024 Accepting new patients
Resource Anesthesiology Associates,PC Anesthesiology CurrentSince Jan 17, 2020 Accepting new patients

Locations

700 Medical Blvd
Englewood, FL 34223
Phone (941) 473-5001

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190

11375 Cortez Blvd
#50
Spring Hill, FL 34613
Phone (352) 592-2753

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

567 Avenue K SE
Winter Haven, FL 33880
Phone (863) 299-1231

88 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 591-8400

260 Patchogue Yaphank Rd
Ste C
East Patchogue, NY 11772
Phone (631) 289-0300

17660 Union Tpke
Fresh Meadows, NY 11366
Phone (212) 774-2474

310 E Shore Rd
Ste 206
Great Neck, NY 11023
Phone (516) 487-7677

600 Mamaroneck Ave
Ste 301
Harrison, NY 10528
Phone 9147238100116

4604 31st Ave
Long Island City, NY 11103
Phone (718) 545-2100

198 Canal St
Ste 501
New York, NY 10013
Phone (212) 219-8010

320 Montauk Hwy
West Islip, NY 11795
Phone (360) 514-9060

Organizations & group practices 8

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 1

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1235135989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053065",
            "telephone_number": "863-680-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053065",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PAVANAJA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "206427",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME141843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.