NPIMap

Individual provider Active NPI

Aravinda Reddy, M.D

  • Nephrology Physician
  • Elizabeth, NJ
National Provider Identifier
1497948640
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA08807500 Issued in NJ
Practice address
240 Williamson St
Suite 205
Elizabeth, NJ 07202-3674
Phone
(908) 289-8340
Fax
(908) 576-3456
NPI assigned
Aug 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M9585 TX
Nephrology Physician 207RN0300X M9585 TX
Nephrology Physician 207RN0300X 25MA08807500 NJ Primary
Internal Medicine Physician 207R00000X 25MA08807500 NJ
Internal Medicine Physician 207R00000X 201461 LA

Addresses

Primary practice location

240 Williamson St
Suite 205
Elizabeth, NJ 07202-3674

Mailing address

1089 New Dover Rd
Edison, NJ 08820-1421
Phone (732) 247-2675

Other identifiers 1

IdentifierTypeStateIssuer
0255467MedicaidNJ

Other names 1

  • Aravinda Pulakurthi Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AravindaReddy@advancedmd-direct.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110412000707 NJ Practitioner - NephrologyPractitioner - Internal Medicine 4981792231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

240 Williamson St
Suite 205
Elizabeth, NJ 07202-3674
Phone (908) 289-8340

Hospital & facility affiliations

  • Trinitas Cranford Dialysis Dialysis facility, Cranford, NJ, CCN 313521
  • Trinitas Hospital Dialysis facility, Elizabeth, NJ, CCN 312318
  • Trinitas Sat Linden Dialysis facility, Linden, NJ, CCN 313503
  • Trinitas Renal Dialysis Satellite Dialysis facility, Elizabeth, NJ, CCN 312336
  • Trinitas Regional Medical Center Hospital, Elizabeth, NJ, CCN 310027
  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051
  • Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074
  • Elmora Hills Health & Rehabilitation Center Nursing home, Elizabeth, NJ, CCN 315010

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
97.5
Improvement activities
40
Cost
77.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08807500NJMDInternal Medicine Physician
M9585TXMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aravinda Reddy MD PA Internal Medicine CurrentSince Nov 1, 2011 Accepting new patients
Lakeside Physician Associates, LLC Past Accepting new patients
Trinitas Regional Medical Center Past Accepting new patients
Preferred Partners Specialty Care Inc Internal Medicine PastSince Apr 13, 2022 Accepting new patients

Locations

255 Williamson St
Elizabeth, NJ 07202
Phone (732) 574-0742

225 W Jersey St
Elizabeth, NJ 07202
Phone (732) 599-0959

240 Williamson St
Ste 205
Elizabeth, NJ 07202
Phone (908) 289-2070

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

Interoperability endpoints

  • Direct secure messaging: aravindareddy@advancedmd-direct.com
  • Direct secure messaging: aravindareddymdpa.aravindareddy@121302.advancedmd-direct.com

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 9

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1497948640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1089 NEW DOVER RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201421",
            "telephone_number": "732-247-2675",
            "fax_number": "732-645-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLIAMSON ST",
            "address_2": "SUITE 205",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023674",
            "telephone_number": "908-289-8340",
            "fax_number": "908-576-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "ARAVINDA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M9585",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "M9585",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA08807500",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08807500",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "201461",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0255467",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AravindaReddy@advancedmd-direct.com",
            "affiliation": "N",
            "endpointDescription": "HIE Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "240 Williamson St Ste 205",
            "city": "Elizabeth",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "072023672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ARAVINDA",
            "last_name": "PULAKURTHI",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.