Individual provider Active NPI

Prakash Patlolla Reddy, M.D.,

  • Psychiatry Physician
  • Rochester, NY
National Provider Identifier
1376595223
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
182152 Issued in NY
Practice address
1597 Ridge Rd W
Suite # 301
Rochester, NY 14615-2513
Phone
(585) 314-7595
Fax
(585) 368-0860
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 182152 NY Primary

Addresses

Primary practice location

1597 Ridge Rd W
Suite # 301
Rochester, NY 14615-2513

Mailing address

835 W Main St
Rochester, NY 14611-2335
Phone (585) 368-6550

Other identifiers 4

IdentifierTypeStateIssuer
00357497MedicaidNY
0010182152OtherNYBLUE CHOICE
RC60182152OtherDOCTORS HEALTH PLAN
MDG569OtherNYPREFERRED CARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address preddy50885@direct.urmc.rochester.edu Direct
Direct Messaging Address preddy50885@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050609000643 NY Practitioner - Psychiatry 4385687383 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians
Catholic Charities of the Diocese of RochesterGroup PAC ID 0345334272, 11 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

79 N Clinton Ave
Rochester, NY 14604-1407
Phone (585) 546-7220

87 N Clinton Ave
Rochester, NY 14604-1407

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182152NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester Current Accepting new patients
University of Rochester Department of Psychiatry Clinical Group Psychiatry CurrentSince Apr 25, 2017 Accepting new patients
University of Rochester CurrentSince Apr 25, 2017 Accepting new patients
Finger Lakes Area Counseling and Recovery Agency, Inc. CurrentSince Jul 4, 2018 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
University of Rochester Psychiatry CurrentSince Apr 25, 2017 Accepting new patients
County of Genesee County Treasurer Past Accepting new patients
Rochester Rehabilitation Center Past Accepting new patients
County of Genesee County Treasurer PastSince Mar 2, 1998 Accepting new patients

Locations

28 E Main St
Clifton Springs, NY 14432
Phone (315) 462-9466

81 Lake Ave
Rochester, NY 14608
Phone (585) 368-6900

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

300 Crittenden Blvd
Rochester, NY 14642
Phone (585) 275-3569

339 East Ave
Ste 303
Rochester, NY 14604
Phone (315) 462-9466

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/7c4ed6b7-c140-41eb-bc5a-5ee81640f80d/
  • Direct secure messaging: preddy50885@direct.urmc.rochester.edu

Organizations & group practices 10

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 2

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1376595223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 W MAIN ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146112335",
            "telephone_number": "585-368-6550",
            "fax_number": "585-368-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1597 RIDGE RD W",
            "address_2": "SUITE # 301",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146152513",
            "telephone_number": "585-314-7595",
            "fax_number": "585-368-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PRAKASH",
        "middle_name": "PATLOLLA",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "182152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00357497",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "0010182152",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOCTORS HEALTH PLAN",
            "identifier": "RC60182152",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "MDG569",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "preddy50885@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "preddy50885@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.