NPIMap

Individual provider Active NPI

Medapally P Reddy, M.D.

  • Internal Medicine Physician
  • Ridgway, PA
National Provider Identifier
1366472979
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD056128L Issued in PA
Practice address
99 Hospital St
Ridgway, PA 15853-1948
Phone
(814) 788-5660
Fax
(814) 788-5663
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD056128L PA Primary
Nephrology Physician 207RN0300X 32042 OK

Addresses

Primary practice location

99 Hospital St
Ridgway, PA 15853-1948

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-6560

Other identifiers 1

IdentifierTypeStateIssuer
001540250MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040917000075 PA Practitioner - Internal Medicine 6002884137 Reassigns benefits to 2 organizations
Practice locations: Ridgway, PA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Healthcare Clinic LLCGroup PAC ID 5395274856, 3 clinicians

Practice addresses (Care Compare)

4386 Sturbridge Dr
Harrisburg, PA 17110-3668
Phone (814) 923-3719

Hospital & facility affiliations

  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD056128LPAMDInternal Medicine Physician
32042OKMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Care Connect Home Health LLC Current Accepting new patients
Apogee Medical Group of Pennsylvania PC Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Prime Healthcare Clinic LLC Internal Medicine CurrentSince Jan 1, 2025 Accepting new patients
Apogee Medical Group of Pennsylvania PC Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Elk Regional Health Center Internal Medicine Past Accepting new patients
Elk Regional Health Center, Inc. Past Accepting new patients

Locations

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

4386 Sturbridge Dr
Harrisburg, PA 17110
Phone (717) 652-4924

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

763 Johnsonburg Rd
Saint Marys, PA 15857
Phone (814) 788-8000

Interoperability endpoints

  • Direct secure messaging: medapallyreddy@prime.medentdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Care Connect Home Health LLCHarrisburg, PA, CCN 398401 Home health agency 5% Or Greater Direct Ownership Interest (22.5%)
W-2 Managing Employee (22.5%)		 Apr 10, 2025
Apr 10, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 7

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1366472979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-6560",
            "fax_number": "814-375-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 HOSPITAL ST",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158531948",
            "telephone_number": "814-788-5660",
            "fax_number": "814-788-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MEDAPALLY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD056128L",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OK",
            "license": "32042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001540250",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgway, PA

Sources for this page

Verify at the official NPI Registry.