Individual provider Active NPI

Chatla V.R Reddy, M.D

  • Interventional Cardiology Physician
  • Brooklyn, NY
National Provider Identifier
1346371309
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
117822 Issued in NY
Practice address
8714 5TH Ave
2ND Floor
Brooklyn, NY 11209-5204
Phone
(718) 836-3333
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 117822 NY Primary

Addresses

Primary practice location

8714 5TH Ave
2ND Floor
Brooklyn, NY 11209-5204

Mailing address

9 Esmac CT West
Staten Island, NY 10304-1200
Phone (718) 667-6487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070426000311 PA Practitioner - Cardiovascular Disease (Cardiology) 0749250389 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
117822NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Apr 1, 2007 Accepting new patients
Park Slope Medical Service PC Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Organizations & group practices 3

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346371309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 ESMAC CT WEST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041200",
            "telephone_number": "718-667-6487",
            "fax_number": "718-667-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8714 5TH AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095204",
            "telephone_number": "718-836-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "CHATLA",
        "middle_name": "V.R",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "117822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.