Gopal Reddy M.D., P.C.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

77-237 Issued in NM

Legal business name

GOPAL REDDY M.D., P.C.

Practice address

500 Walter St NE Ste 204
Albuquerque, NM 87102-2543

Phone

(505) 842-5518

Fax

(505) 247-8509

NPI assigned

Jan 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gopal Reddy, MDNPI 1891890620

Title

President

Phone

(505) 842-5518

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NEW MEXICO VASCULAR DIAGNOSTICS Other name

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gopal Reddy, MD

  • Vascular Surgery Physician
  • Albuquerque, NM
  • NPI 1891890620
  Medicare reassignment NPD Authorized official
• Renee E Thompson, MD

  • Surgery Physician
  • Albuquerque, NM
  • NPI 1659392447
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1407031040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE STE 204",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022543",
            "telephone_number": "505-842-5518",
            "fax_number": "505-247-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE STE 204",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022543",
            "telephone_number": "505-842-5518",
            "fax_number": "505-247-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOPAL REDDY M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "GOPAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-842-5518",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NM",
            "license": "77-237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09449",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW MEXICO VASCULAR DIAGNOSTICS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tre Goodwin
• Rachel Lauren Goodwyn, ACNPC-AG
• Hailey Goold, ATC
• Krystal Goolsby
• Taylor Goot, M.D.
• Ramesh Gopal, MD
• Sarah Beth Gopman, M.D.
• Kathryn Jane Gorab, PA
• Ruthann Goradia
• Cynthia Goranson, HAD

• Vascular Surgery Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Vascular Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.