Individual provider Active NPI

Avinash Konudulla Reddy, M.D

  • Urology Physician
  • Buffalo, NY
National Provider Identifier
1447570114
Registry record updated Oct 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
280760-1 Issued in NY
Practice address
100 High St
Room 374
Buffalo, NY 14203-1126
Phone
(716) 859-7756
Fax
(716) 859-7760
NPI assigned
Jun 4, 2010
Last updated
Oct 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 280760-1 NY Primary

Addresses

Primary practice location

100 High St
Room 374
Buffalo, NY 14203-1126

Mailing address

17682 George Moran Dr
Eden Prairie, MN 55347-1085
Phone (952) 836-4449

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170615001015 NY Practitioner - Urology 8628346608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Minnesota Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

625 Madison Ave
FL 2
New York, NY 10022-1800
Phone (212) 241-9955

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280760-1NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Urology CurrentSince May 3, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 3, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Locations

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

234 E 85th St
Fl 2
New York, NY 10028
Phone (212) 241-6585

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

5 E 98th St
Fl 6
New York, NY 10029
Phone (212) 241-2221

625 Madison Ave
Fl 2
New York, NY 10022
Phone (212) 241-4812

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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 6

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": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507852800000",
    "number": "1447570114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17682 GEORGE MORAN DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471085",
            "telephone_number": "952-836-4449",
            "fax_number": "952-934-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "address_2": "ROOM 374",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-7756",
            "fax_number": "716-859-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "AVINASH",
        "middle_name": "KONUDULLA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2017-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "280760-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.