NPIMap

Individual provider Active NPI

Manohar G Reddy, MD

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1356385165
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0073885 Issued in FL
Practice address
2551 W Eau Gallie Blvd
Suite 101
Melbourne, FL 32935
Phone
(321) 752-5544
Fax
(321) 752-5957
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0073885 FL Primary

Addresses

Primary practice location

2551 W Eau Gallie Blvd
Suite 101
Melbourne, FL 32935

Mailing address

2551 W Eau Gallie Blvd
Suite 101
Melbourne, FL 32935
Phone (321) 752-5544

Other identifiers 2

IdentifierTypeStateIssuer
42287OtherFLBCBS PROVIDER NUMBER
255599900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050308000915 FL Practitioner - Internal Medicine 7911951439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2551 W Eau Galle Blvd
Suite 101
Melbourne, FL 32935-8954
Phone (321) 752-5544

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0073885FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Manohar G Reddy MD PA Internal Medicine CurrentSince May 1, 2006 Accepting new patients

Locations

2551 W Eau Gallie Blvd
Ste 101
Melbourne, FL 32935
Phone (321) 752-5544

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEGCCD
  • Direct secure messaging: mreddy23000@epicdirect.hf.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/EEGCCD/Endpoint/EEGCCD

Organizations & group practices 1

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 11

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1356385165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 W EAU GALLIE BLVD",
            "address_2": "SUITE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "321-752-5544",
            "fax_number": "321-752-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 W EAU GALLIE BLVD",
            "address_2": "SUITE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "321-752-5544",
            "fax_number": "321-752-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MANOHAR",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0073885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "42287",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255599900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.