Individual provider Active NPI

Korrapati S Reddy, MD

  • Emergency Medicine Physician
  • Perth Amboy, NJ
National Provider Identifier
1245225788
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA06935100 Issued in NJ
Practice address
530 New Brunswick Ave
Perth Amboy, NJ 08861-3674
Phone
(732) 442-3700
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA06935100 NJ Primary
Internal Medicine Physician 207R00000X 25MA06935100 NJ

Addresses

Primary practice location

530 New Brunswick Ave
Perth Amboy, NJ 08861-3674

Mailing address

66 W Gilbert St
Tinton Falls, NJ 07701-4918
Phone (732) 212-0060

Other identifiers 1

IdentifierTypeStateIssuer
8167605MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040526000591 KY Practitioner - Emergency MedicinePractitioner - Internal Medicine 1153318142 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06935100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green Valley Emergency Physicians, LLC Emergency Medicine CurrentSince Jan 31, 2025 Accepting new patients
Pine Mountain Emergency Group Limited Liability Company Emergency Medicine CurrentSince Dec 12, 2019 Accepting new patients
Appalachian Regional Healthcare, Inc Emergency Medicine Past Accepting new patients
Appalachian Regional Healthcare, Inc. Emergency Medicine Past Accepting new patients

Locations

80 Hospital Dr
Barbourville, KY 40906
Phone (606) 545-5500

81 Ball Park Rd
Harlan, KY 40831
Phone (606) 573-8100

3600 Cumberland Ave
Middlesboro, KY 40965
Phone (606) 237-1700

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

5000 Ky Route 321
Prestonsburg, KY 41653
Phone (606) 886-7645

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1245225788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014918",
            "telephone_number": "732-212-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613674",
            "telephone_number": "732-442-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "KORRAPATI",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA06935100",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06935100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8167605",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

Verify at the official NPI Registry.