Individual provider Active NPI

Manoj Adavelly Reddy, MD

  • Radiation Oncology Physician
  • Dallas, TX
National Provider Identifier
1619977329
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
L1182 Issued in TX
Practice address
5925 Forest LN Ste 416
Dallas, TX 75230-2713
Phone
(281) 772-6270
NPI assigned
Jul 22, 2005
Last updated
Apr 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X L1182 TX Primary

Addresses

Primary practice location

5925 Forest LN Ste 416
Dallas, TX 75230-2713

Mailing address

5925 Forest LN Ste 416
Dallas, TX 75230-2713
Phone (281) 772-6270

Other practice location 1

131 Spring Hill Rd
Longview, TX 75605-1147
Phone (903) 544-6888

Other identifiers 2

IdentifierTypeStateIssuer
1590556-02MedicaidTX
1590556-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090501000185 TX Practitioner - Radiation OncologyPractitioner - Orthopedic SurgeryPractitioner - Pulmonary DiseasePractitioner - Medical Oncology 0648253815 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L1182TXMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA Radiation Oncology CurrentSince Mar 15, 2023 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
North Texas Cancer Center LP Radiation Oncology CurrentSince Jan 1, 2015 Accepting new patients
Texas Oncology PA Radiation Oncology Current Accepting new patients
Texas Oncology PA Radiation Oncology CurrentSince Mar 15, 2023 Accepting new patients

Locations

3410 Worth St
Ste 100
Dallas, TX 75246
Phone (214) 370-1000

7777 Forest Ln
Ste C707
Dallas, TX 75230
Phone (972) 566-3000

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

4201 Medical Center Dr
Ste 180
McKinney, TX 75069
Phone (817) 261-4906

5948 W Parker Rd
#200
Plano, TX 75093
Phone (469) 259-9822

Interoperability endpoints

  • Direct secure messaging: manoj.reddy@txo.ikm.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1619977329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 FOREST LN STE 416",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302713",
            "telephone_number": "281-772-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 FOREST LN STE 416",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302713",
            "telephone_number": "281-772-6270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Spring Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756051147",
            "country_code": "US",
            "telephone_number": "903-544-6888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MANOJ",
        "middle_name": "ADAVELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "L1182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1590556-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1590556-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.