Individual provider Active NPI

Madhavi Reddy, M.D.

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1467565499
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
219727 Issued in NY
Practice address
240 Willoughby St
Suite 11a
Brooklyn, NY 11201-5465
Phone
(718) 250-8867
Fax
(718) 250-8864
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 219727 NY Primary

Addresses

Primary practice location

240 Willoughby St
Suite 11a
Brooklyn, NY 11201-5465

Mailing address

240 Willoughby St
Suite 11a
Brooklyn, NY 11201-5465
Phone (718) 250-8867

Other identifiers 1

IdentifierTypeStateIssuer
02457858MedicaidNY

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
I20040617001687 NY Practitioner - Gastroenterology 3375527021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TBHC Physician Services PCGroup PAC ID 9133265317, 111 clinicians

Practice addresses (Care Compare)

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000

Hospital & facility affiliations

  • Brooklyn Hospital Center - Downtown Campus Hospital, Brooklyn, NY, CCN 330056

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy51
Upper gastrointestinal (GI) endoscopy for acid reflux20

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
TBHC Physician Services PC CurrentSince Jul 27, 2014 Accepting new patients
Madhavi Reddy MD PC PastSince Apr 30, 2004 Accepting new patients
Caledonian Health Center PastSince Dec 1, 2004 Accepting new patients
TBHC Medical Services PC Past Accepting new patients

Locations

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

99 Division Ave
Brooklyn, NY 11249
Phone (718) 349-8500

Networks

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

Interoperability endpoints

  • Direct secure messaging: mreddy8764@prd.direct.tbh.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1467565499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WILLOUGHBY ST",
            "address_2": "SUITE 11A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015465",
            "telephone_number": "718-250-8867",
            "fax_number": "718-250-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLOUGHBY ST",
            "address_2": "SUITE 11A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015465",
            "telephone_number": "718-250-8867",
            "fax_number": "718-250-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MADHAVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "219727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02457858",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.