Individual provider Active NPI

Gaddum Duemani Reddy, M.D., PH.D.

  • Neurological Surgery Physician
  • Arlington, TX
National Provider Identifier
1578894267
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
BP10034726 Issued in TX
Practice address
515 W Mayfield Rd Ste 407
Arlington, TX 76014-2085
Phone
(713) 392-7289
NPI assigned
Jan 20, 2010
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X BP10034726 TX Primary

Addresses

Primary practice location

515 W Mayfield Rd Ste 407
Arlington, TX 76014-2085

Mailing address

5024 Breezewind LN
Fort Worth, TX 76123-6009
Phone (713) 392-7289

Other practice location 1

3141 E Broad St Ste 335
Mansfield, TX 76063-6426
Phone (682) 219-0357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170822000807 NY Practitioner - Neurosurgery 7810269107 Reassigns benefits to 1 organization
I20211019002755 TX Practitioner - Neurosurgery 7810269107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurosurgical Associates of North Texas PLLCGroup PAC ID 8921234832, 14 clinicians

Practice addresses (Care Compare)

515 W Mayfield Rd
Arlington, TX 76014-2085
Phone (682) 219-0357

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion67
Laminectomy or laminotomy (partial removal of spine bones)24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10034726TXMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Associates of North Texas PLLC Neurological Surgery CurrentSince Dec 1, 2021 Accepting new patients
Neurosurgical Associates of Central New York, LLP CurrentSince Jul 15, 2017 Accepting new patients
Upstate Neurosurgery LLP Neurological Surgery CurrentSince Jul 15, 2017 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Cardiology Specialists of North Texas, PLLC Past Accepting new patients

Locations

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

4900 Broad Rd
Ste 1352
Syracuse, NY 13215
Phone (315) 464-4470

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

515 W Mayfield Rd
Ste 407
Arlington, TX 76014
Phone (682) 219-0357

909 9th Ave
Ste 201
Fort Worth, TX 76104
Phone (214) 575-5885

3141 E Broad St
Ste 335
Mansfield, TX 76063
Phone (682) 219-0357

Organizations & group practices 5

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": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1578894267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5024 BREEZEWIND LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761236009",
            "telephone_number": "713-392-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W MAYFIELD RD STE 407",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142085",
            "telephone_number": "713-392-7289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3141 E Broad St Ste 335",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760636426",
            "country_code": "US",
            "telephone_number": "682-219-0357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "GADDUM",
        "middle_name": "DUEMANI",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-20",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "BP10034726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.