Jyothi J Reddy, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C144069 Issued in CA

Practice address

4060 Fairmount Ave.
Pediatrics Department
San Diego, CA 92105

Phone

(619) 255-9154

Fax

(619) 795-9847

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jyothi.reddy.p1@direct.lamaestra.nextgenshare.com
• Direct secure messaging: jyothi.reddy.p64@direct.tenet.nextgenshare.com

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.

• Healthtexas Provider Network

  dba Family Medical Center at Terrell

  • Family Medicine Physician
  • Terrell, TX
  • NPI 1063417699

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1306869300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 FAIRMOUNT AVE",
            "address_2": "PEDIATRICS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92105",
            "telephone_number": "619-255-9154",
            "fax_number": "619-795-9847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FAIRMOUNT AVE.",
            "address_2": "PEDIATRICS DEPARTMENT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92105",
            "telephone_number": "619-255-9154",
            "fax_number": "619-795-9847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "JYOTHI",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G2825",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C144069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE AMERICAN BOARD OF PEDIATRICS",
            "identifier": "25622",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133349408",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reddy and Reddy Dental Corporation
• Reddy Biomedical Corp
• Reddy Medical Corporation
• Dana Ann Copeland Reddy, MD
• Divya K Reddy, MD
• Laya Manthani Reddy, M.D.
• Manorama M Reddy, M.D.
• Natasha Reddy, PSYD
• Nihaal Reddy, MD
• Nithin C Reddy, MD

• Pediatrics Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.