Individual provider Active NPI

Madhu Bandaru Reddy, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Aurora, CO
National Provider Identifier
1609818525
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
50985 Issued in CO
Practice address
12250 E Iliff Ave
#300
Aurora, CO 80014-6318
Phone
(303) 306-4321
Fax
(720) 524-1551
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-043524 OH
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 50985 CO Primary

Addresses

Primary practice location

12250 E Iliff Ave
#300
Aurora, CO 80014-6318

Mailing address

12250 E Iliff Ave
#300
Aurora, CO 80014-6318
Phone (303) 306-4321

Other identifiers 1

IdentifierTypeStateIssuer
07400772MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20130904000263 CO Practitioner - Internal Medicine 5991896177 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-043524OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Colorado PC Internal Medicine CurrentSince Jul 20, 2013 Accepting new patients
Inpatient Consultants of Colorado PC Internal Medicine CurrentSince Jul 20, 2013 Accepting new patients
Inpatient Consultants of Colorado, PC Internal Medicine Past Accepting new patients

Locations

1800 S Potomac St
Aurora, CO 80012
Phone (720) 213-1700

12250 E Iliff Ave
Ste 300
Aurora, CO 80014
Phone (720) 524-1550

850 E Harvard Ave
Ste 305
Denver, CO 80210
Phone (303) 778-5910

2000 S Colorado Blvd
Ste 420
Denver, CO 80222
Phone (720) 524-1550

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

1660 Allison St
Lakewood, CO 80214
Phone (303) 232-7177

150 Spring St
Morrison, CO 80465
Phone (303) 697-8181

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1609818525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12250 E ILIFF AVE",
            "address_2": "#300",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800146318",
            "telephone_number": "303-306-4321",
            "fax_number": "720-524-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12250 E ILIFF AVE",
            "address_2": "#300",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800146318",
            "telephone_number": "303-306-4321",
            "fax_number": "720-524-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MADHU",
        "middle_name": "BANDARU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-043524",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CO",
            "license": "50985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07400772",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.