Puli Pravin Reddy, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

046220 Issued in GA

Practice address

1418 Dresden Drive
120
Atlanta, GA 30319

Phone

(404) 481-5089

Fax

(404) 795-0461

NPI assigned

Nov 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Midtown Plastic Surgery, LLC

  • Plastic Surgery Physician
  • Atlanta, GA
  • NPI 1790939783
  NPD (past) Authorized official

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1487835260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 DRESDEN DRIVE",
            "address_2": "SUITE 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30319",
            "telephone_number": "404-481-5089",
            "fax_number": "404-795-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 DRESDEN DRIVE",
            "address_2": "120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30319",
            "telephone_number": "404-481-5089",
            "fax_number": "404-795-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PULI",
        "middle_name": "PRAVIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "240739",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "046220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "26-3609921",
            "identifier": "TAX ID",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kattegummula Anjali Reddy, LPC
• Manasvi Jada Reddy
• Poojitha Reddy, DO
• Praveen C Reddy, MD
• Priyanka Reddy
• Ramesh G Reddy, M.D.
• Sheethal Reddy, PH.D.
• Shriya Jakkidi Reddy, DO
• Silpa Reddy, MD
• Sisira Reddy

• Plastic and Reconstructive Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Plastic and Reconstructive Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.