NPIMap

Organization Active NPI

Reddy Medical Group Inc

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1407995038
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A55459 Issued in CA
Legal business name
REDDY MEDICAL GROUP INC
Practice address
7045 N Maple Ave Ste 108
Fresno, CA 93720-8008
Phone
(559) 326-7393
Fax
(559) 369-2488
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Authorized official

Name
Kiran Reddy, MDNPI 1588778435
Title
Owner
Phone
(559) 326-7393

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A55459 CA Primary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X A49497 CA
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 18274 CA

Addresses

Primary practice location

7045 N Maple Ave Ste 108
Fresno, CA 93720-8008

Mailing address

7045 N Maple Ave Ste 108
Fresno, CA 93720-8008
Phone (559) 326-7393

Other identifiers 1

IdentifierTypeStateIssuer
GR0092800MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050712000698 CA Part B Supplier - Clinic/Group Practice 3173559044 Receives reassigned benefits from 5 practitioners
Practice locations: Fresno, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1407995038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7045 N MAPLE AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208008",
            "telephone_number": "559-326-7393",
            "fax_number": "559-369-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7045 N MAPLE AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208008",
            "telephone_number": "559-326-7393",
            "fax_number": "559-369-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDDY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "KIRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-326-7393",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55459",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A49497",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18274",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.