Organization Active NPI

Anuradha Reddy MD

  • Rheumatology Physician
  • Baltimore, MD
National Provider Identifier
1407061427
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
D006305 Issued in MD
Legal business name
ANURADHA REDDY MD
Practice address
821 N Eutaw St Ste 312
Baltimore, MD 21201-6309
Phone
(410) 225-8153
Fax
(410) 298-8225
NPI assigned
May 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Anuradha Reddy, MDNPI 1760559009
Title
Owner
Phone
(410) 461-2239

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X D006305 MD
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X D006305 MD Primary

Addresses

Primary practice location

821 N Eutaw St Ste 312
Baltimore, MD 21201-6309

Mailing address

10404 Kingsbridge Rd
Ellicott City, MD 21042-5852
Phone (410) 461-2239

Other identifiers 1

IdentifierTypeStateIssuer
1407061427MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120621000326 MD Part B Supplier - Clinic/Group Practice 8325202492 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D1048510Anuradha Reddy MD821 N Eutaw St Ste 303, Baltimore, MD 21201Provider-performed microscopyDec 4, 2027

National Provider Directory

National Provider Directory

Locations

821 N Eutaw St
Ste 312
Baltimore, MD 21201
Phone (410) 225-4455

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1407061427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10404 KINGSBRIDGE RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425852",
            "telephone_number": "410-461-2239",
            "fax_number": "410-298-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N EUTAW ST STE 312",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212016309",
            "telephone_number": "410-225-8153",
            "fax_number": "410-298-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANURADHA REDDY MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-12",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "ANURADHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-461-2239",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D006305",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MD",
            "license": "D006305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407061427",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.