Individual provider Active NPI

Dheeraj Soma Reddy, M.D.

  • Family Medicine Physician
  • Venice, FL
National Provider Identifier
1457364028
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME96289 Issued in FL
Practice address
1720 E Venice Ave FL 2
Venice, FL 34292-3190
Phone
(941) 483-9730
Fax
(941) 483-9745
NPI assigned
Aug 14, 2006
Last updated
Mar 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME96289 FL Primary

Addresses

Primary practice location

1720 E Venice Ave FL 2
Venice, FL 34292-3190

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dheeraj.reddy.1@4692.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20061113000455 FL Practitioner - Family Practice 5890696983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

13807 Tamiami TRL
North Port, FL 34287-2069
Phone (941) 257-1108

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (239) 936-1343

13815 Tamiami TRL
North Port, FL 34287-2069
Phone (941) 426-4900

13823 Tamiami TRL
North Port, FL 34287-2069
Phone (941) 888-0770

150 W McKenzie St
Punta Gorda, FL 33950-5500
Phone (941) 621-6476

1700 E Venice Ave
Venice, FL 34292-3190
Phone (941) 800-4700

171 Ctr Rd
Venice, FL 34285-5572
Phone (941) 499-5407

1720 E Venice Ave
Venice, FL 34292-3190
Phone (941) 483-9700

177 Ctr Rd
Venice, FL 34285-5572
Phone (941) 207-5350

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2315 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 613-2222

2335 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 787-7665

2343 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 629-2900

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

3000 S McCall Rd
Englewood, FL 34224-8616
Phone (941) 406-9029

4130 Tamiami TRL
Suite 2
Port Charlotte, FL 33952-9207
Phone (941) 787-7100

4881 Palm Beach Blvd
Suite 100
Fort Myers, FL 33905-3217
Phone (239) 693-9191

8383 S Tamiami TRL
Sarasota, FL 34238-2901
Phone (941) 244-9430

900 Pine St
Suite 221
Englewood, FL 34223-4458
Phone (941) 548-1708

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Jan 3, 2022 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Jan 3, 2022 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

2237 Lithia Center Ln
Valrico, FL 33596
Phone (813) 662-0123

1720 E Venice Ave
Fl 2
Venice, FL 34292
Phone (844) 366-9362

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dheeraj.reddy.1@4290.direct.athenahealth.com
  • Direct secure messaging: dheeraj.reddy.1@4692.direct.athenahealth.com

Organizations & group practices 2

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 7

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1457364028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E VENICE AVE FL 2",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342923190",
            "telephone_number": "941-483-9730",
            "fax_number": "941-483-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "DHEERAJ",
        "middle_name": "SOMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME96289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dheeraj.reddy.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1720 E Venice Ave Fl 2",
            "city": "Venice",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342923190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.