Dwaraknath Ponnalur Reddy, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A34093 Issued in CA

Practice address

811 E 11TH St
Suite 208
Upland, CA 91786-4871

Phone

(909) 629-5540

Fax

(909) 946-3070

NPI assigned

Aug 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: casacolina@direct.casacolina.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chaparral Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Pomona, CA
  • NPI 1477733624
  Medicare reassignment NPD
• Dwaraknath P. Reddy, M.D.

  • Gastroenterology Physician
  • Pomona, CA
  • NPI 1679707046
  NPD (past) Authorized official
• Casa Colina Hospital and Centers for Healthcare

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1952777245
  NPD
• Chaparral Medical Group Inc.

  • Cardiovascular Disease Physician
  • Upland, CA
  • NPI 1639869605
  NPD
• Chaparral Medical Group, Inc.

  • Pulmonary Disease Physician
  • Pomona, CA
  • NPI 1609292051
  NPD
• Casa Colina Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Pomona, CA
  • NPI 1518972322
  NPD (past)
• Dwaraknath P. Reddy, M.D.

  • Gastroenterology Physician
  • Upland, CA
  • NPI 1578762779
  NPD (past)
• Episource LLC

  • Nurse Practitioner
  • Gardena, CA
  • NPI 1225390289
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417964917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 E 11TH ST",
            "address_2": "SUITE 208",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864871",
            "telephone_number": "909-629-5540",
            "fax_number": "909-946-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E 11TH ST",
            "address_2": "SUITE 208",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864871",
            "telephone_number": "909-629-5540",
            "fax_number": "909-946-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "DWARAKNATH",
        "middle_name": "PONNALUR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A34093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A340931",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Realm Healthcare Inc
• Kelly Reardon
• Jeffrey Craig Rebish, MD
• Sandra Lee Rebish, MD
• Recovery Treatment Center
• Helen Redmond
• Rushmi Reehal, PA-C
• Rania N Refaat, DDS
• Nerges Mohamed Refai
• Regional Medical Services (Regional Imaging Services)

• Gastroenterology Physician in Upland, CA
• Providers in Upland, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.