Individual provider Active NPI

Srija Reddy Kesireddy, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Pontiac, MI
National Provider Identifier
1538055355
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
461 West Huron Street Suite 107
Pontiac, MI 48341
Phone
(248) 724-7600
Fax
(248) 857-7141
NPI assigned
Jun 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI Primary

Addresses

Primary practice location

461 West Huron Street Suite 107
Pontiac, MI 48341

Mailing address

PO Box 430150
Pontiac, MI 48343-0150
Phone (248) 724-7600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address srijareddy.kesireddy.p1@direct.oihn.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260602003961 MI Practitioner - Family Practice 0345711156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 430150
Pontiac, MI 48343

PO Box
Suite 5478
Pawtucket, RI 02862

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Integrated Healthcare Network Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1538055355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430150",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483430150",
            "telephone_number": "248-724-7600",
            "fax_number": "248-857-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 WEST HURON STREET SUITE 107",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48341",
            "telephone_number": "248-724-7600",
            "fax_number": "248-857-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESIREDDY",
        "first_name": "SRIJA REDDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-17",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srijareddy.kesireddy.p1@direct.oihn.nextgenshare.com",
            "affiliation": "N",
            "address_1": "461 W Huron St",
            "city": "Pontiac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483411601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.