Organization Active NPI

Infectious Diseases Associates, LLP

  • Infectious Disease Physician
  • Beaumont, TX
National Provider Identifier
1235226713
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
J4983 Issued in TX
Legal business name
INFECTIOUS DISEASES ASSOCIATES, LLP
Practice address
3030 North St
Suite 460
Beaumont, TX 77702
Phone
(409) 892-6099
Fax
(409) 892-2210
NPI assigned
Oct 6, 2006
Last updated
Jan 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Dr. Keshava C Reddy, MDNPI 1932296407
Title
MD
Phone
(409) 892-6099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X
Infectious Disease Physician 207RI0200X J4983 TX Primary

Addresses

Primary practice location

3030 North St
Suite 460
Beaumont, TX 77702

Mailing address

3030 North St
Suite 460
Beaumont, TX 77702
Phone (409) 892-6099

Other identifiers 2

IdentifierTypeStateIssuer
00073NOtherTXBLUE CROSS BLUE SHIELD
079781301MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050714000495 TX Part B Supplier - Clinic/Group Practice 8921034570 Receives reassigned benefits from 3 practitioners
Practice locations: Beaumont, TX

National Provider Directory

National Provider Directory

Locations

3030 North St
Ste 460
Beaumont, TX 77702
Phone (409) 892-6099

2001 9th Ave
Ste 202
Port Arthur, TX 77642
Phone (409) 985-3479

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1235226713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 NORTH ST",
            "address_2": "SUITE 460",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77702",
            "telephone_number": "409-892-6099",
            "fax_number": "409-892-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 NORTH ST",
            "address_2": "SUITE 460",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77702",
            "telephone_number": "409-892-6099",
            "fax_number": "409-892-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES ASSOCIATES, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "KESHAVA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "409-892-6099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "J4983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00073N",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079781301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.