Individual provider Active NPI

Aditya Reddy Boddu

  • Interventional Cardiology Physician
  • Fort Myers, FL
National Provider Identifier
1497917744
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME143336 Issued in FL
Practice address
16261 Bass Rd Ste 300
Fort Myers, FL 33908-3671
Phone
(239) 343-6410
Fax
(239) 343-4014
NPI assigned
Jun 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X ME143336 FL Primary
Cardiovascular Disease Physician 207RC0000X 01068916A IN
Cardiovascular Disease Physician 207RC0000X ME143336 FL

Addresses

Primary practice location

16261 Bass Rd Ste 300
Fort Myers, FL 33908-3671

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-6410

Other identifiers 1

IdentifierTypeStateIssuer
104990800MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aboddu221386@Direct.leememorial.org Lee Memorial Health System

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
I20200102002548 FL Practitioner - Cardiovascular Disease (Cardiology) 3577790245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

13340 Metro Pkwy
Fort Myers, FL 33966-4818

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-2606

16261 Bass Rd
Suite 300
Fort Myers, FL 33908-3671
Phone (239) 343-6410

16281 Bass Rd
Fort Myers, FL 33908-9687

23450 Via Coconut PT
Estero, FL 34135-1877
Phone (239) 468-0120

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000

8960 Colonial Ctr Dr
Fort Myers, FL 33905-7810

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting195
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME143336FLMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Dec 6, 2019 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Dec 6, 2019 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

16261 Bass Rd
Ste 300
Fort Myers, FL 33908
Phone (239) 274-8866

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: aboddu221386@direct.leememorial.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 3

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": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1497917744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-6410",
            "fax_number": "239-343-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16261 BASS RD STE 300",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083671",
            "telephone_number": "239-343-6410",
            "fax_number": "239-343-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODDU",
        "first_name": "ADITYA",
        "middle_name": "REDDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME143336",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01068916A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME143336",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104990800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aboddu221386@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.