Individual provider Active NPI

Michael Prasad Reddy-Miller, MD

  • Internal Medicine Physician
  • Macon, GA
National Provider Identifier
1538621172
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11600 Issued in GA
Practice address
777 Hemlock St
Macon, GA 31201-2102
Phone
(478) 633-1000
NPI assigned
Apr 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 11600 GA Primary

Addresses

Primary practice location

777 Hemlock St
Macon, GA 31201-2102

Mailing address

790 1St St
Macon, GA 31201-6874
Phone (478) 633-1000

Other practice location 1

764 Pine Street
Macon, GA 31201
Phone (478) 633-1721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230928002812 NC Practitioner - Internal Medicine 1153656871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4800 S Croatan Hwy
Nags Head, NC 27959-9704
Phone (252) 449-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC Family Medicine CurrentSince Sep 14, 2023 Accepting new patients
Health Services of Central Georgia, Inc Family Medicine PastSince Aug 1, 2013 Accepting new patients
The Medical Center of Central Georgia Inc Past Accepting new patients

Locations

4800 S Croatan Hwy
Nags Head, NC 27959
Phone (252) 449-4500

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1538621172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 1ST ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016874",
            "telephone_number": "478-633-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "764 PINE STREET",
            "address_purpose": "LOCATION",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "country_code": "US",
            "telephone_number": "478-633-1721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY-MILLER",
        "first_name": "MICHAEL",
        "middle_name": "PRASAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "11600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.