NPIMap

Individual provider Active NPI

Vivek V Reddy, M.D.

  • Diagnostic Radiology Physician
  • Lakeport, CA
National Provider Identifier
1437163441
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A82747 Issued in CA
Practice address
5176 Hill Rd E
Lakeport, CA 95453-6300
Phone
(707) 262-5030
Fax
(707) 256-3508
NPI assigned
Jul 27, 2006
Last updated
Apr 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A82747 CA Primary

Addresses

Primary practice location

5176 Hill Rd E
Lakeport, CA 95453-6300

Mailing address

PO Box 6102
Novato, CA 94948-6102
Phone (415) 884-3404

Other identifiers 1

IdentifierTypeStateIssuer
00A827470MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223001283 CA Practitioner - Diagnostic Radiology 4183510654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5176 Hill Rd E
Lakeport, CA 95453-6300
Phone (707) 262-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.9 of 100Reported as group
Quality
91.91
Improvement activities
40
Cost
79.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A82747CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Advanced Imaging Medical Associates Inc Diagnostic Radiology CurrentSince Feb 1, 2016 Accepting new patients
Pacific Imaging Consultants, a Medical Group, Inc. Diagnostic Radiology Past Accepting new patients
Solano Imaging Medical Associates Diagnostic Radiology Past Accepting new patients
Upstate Carolina Radiology PA Diagnostic Radiology PastSince Apr 3, 2022 Accepting new patients
Susan Nichols Hostetter M D P a Diagnostic Radiology Past Accepting new patients
Virtual Radiologic Professionals of California, P.a Diagnostic Radiology Past Accepting new patients
White Rock Radiology Associates, L.L.P. Diagnostic Radiology Past Accepting new patients

Locations

1260 S Eliseo Dr
Ste 101
Greenbrae, CA 94904
Phone (415) 461-9033

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

2333 Buchanan St
San Francisco, CA 94115
Phone (415) 563-4321

100 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 696-4140

347 Andrieux St
Sonoma, CA 95476
Phone (707) 935-5000

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1437163441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6102",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949486102",
            "telephone_number": "415-884-3404",
            "fax_number": "415-883-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5176 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300",
            "telephone_number": "707-262-5030",
            "fax_number": "707-256-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "VIVEK",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A82747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A827470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.