Active NPI
Harshavardhan Tathireddy, M.D
- Hematology & Oncology Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 036130674
- Practice address
- 3181 SW Sam Jackson Park Rd, L-579
Oc14Ho , Dept of Hematology and Oncology
Portland, OR 97239 - Phone
- (503) 494-8311
- NPI assigned
- Jun 22, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD210372 | OR | |
| Internal Medicine Physician | 207R00000X | 125055801 | IL | |
| Hospitalist Physician | 208M00000X | 036130674 | IL | |
| Hematology & Oncology Physician | 207RH0003X | 036130674 | IL | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd, L-579
Oc14Ho , Dept of Hematology and Oncology
Portland, OR 97239
Mailing address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-3323
Other practice location 1
201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171
Other practice location 2
Osf St Francis Medical Ctr
Peoria, IL 61637-0001
Phone (309) 655-3863
Other practice location 3
2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 214881 | Other | IL | MEDICARE GROUP PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125055801 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Illinois Medical Services, NFP | Internal Medicine | Current | Accepting new patients |
Locations
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171
2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156
Interoperability endpoints
- htathireddy144457@direct.ohsu.edu
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.
-
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1366670994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-3323",
"fax_number": "708-216-4113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD, L-579",
"address_2": "OC14HO , DEPT OF HEMATOLOGY AND ONCOLOGY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-494-8311"
}
],
"practiceLocations": [
{
"address_1": "201 S 14th St",
"address_purpose": "LOCATION",
"city": "Herrin",
"state": "IL",
"postal_code": "629483631",
"country_code": "US",
"telephone_number": "618-942-2171",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Osf St Francis Medical Ctr",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "IL",
"postal_code": "616370001",
"country_code": "US",
"telephone_number": "309-655-3863",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 S Hospital Dr",
"address_purpose": "LOCATION",
"city": "Murphysboro",
"state": "IL",
"postal_code": "62966",
"country_code": "US",
"telephone_number": "618-684-3156",
"fax_number": "618-351-4895",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TATHIREDDY",
"first_name": "HARSHAVARDHAN",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-22",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD210372",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125055801",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036130674",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "IL",
"license": "036130674",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "214881",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.