Individual provider Active NPI

Shilpa Gopal Reddy, MD

  • Dermatology Physician
  • Albuquerque, NM
National Provider Identifier
1639218639
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD2009-0556 Issued in NM
Practice address
610 Broadway Blvd NE
Albuquerque, NM 87102-2372
Phone
(505) 225-2500
Fax
(505) 225-2025
NPI assigned
Feb 6, 2007
Last updated
Mar 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD2009-0556 NM Primary

Addresses

Primary practice location

610 Broadway Blvd NE
Albuquerque, NM 87102-2372

Mailing address

610 Broadway Blvd NE
Albuquerque, NM 87102-2372
Phone (505) 225-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20101014000223 NM Practitioner - Dermatology 1850583485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of New Mexico School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology of New Mexico LLCGroup PAC ID 6608209606, 5 clinicians

Practice addresses (Care Compare)

610 Broadway Blvd NE
Albuquerque, NM 87102-2372
Phone (505) 225-2500

Merit-based Incentive Payment System (MIPS)

Final score
92.8 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.02

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision133
Removal of tissue1-10
Removal of skin lesions1731
Removal or shaving of skin growth1-10
Skin biopsy484

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology of New Mexico LLC CurrentSince Nov 18, 2019 Accepting new patients

Locations

610 Broadway Blvd NE
Albuquerque, NM 87102
Phone (505) 225-2500

Organizations & group practices 1

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1639218639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-225-2500",
            "fax_number": "505-225-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-225-2500",
            "fax_number": "505-225-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SHILPA",
        "middle_name": "GOPAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NM",
            "license": "MD2009-0556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.