NPIMap

Individual provider Active NPI

Sanjay G Reddy, M.D; M.P.H

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1649459595
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M8944 Issued in TX
Practice address
707 Hollybrook Dr
Longview, TX 75605-2410
Phone
(903) 757-6042
Fax
(903) 291-6034
NPI assigned
Oct 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M8944 TX Primary

Addresses

Primary practice location

707 Hollybrook Dr
Longview, TX 75605-2410

Mailing address

707 Hollybrook Dr
Longview, TX 75605-2410
Phone (903) 757-6042

Other identifiers 1

IdentifierTypeStateIssuer
M8944OtherTXTEXAS MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080501000149 TX Practitioner - Internal Medicine 5193804250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

707 Hollybrook Dr
Longview, TX 75605-2410
Phone (903) 291-6161

Hospital & facility affiliations

  • Onesource Home Care Inc Home health agency, Longview, TX, CCN 679138
  • Accentcare Home Health of Texas Home health agency, Longview, TX, CCN 679090
  • Prime Care Hospice LLC Hospice, Longview, TX, CCN 741756
  • Longview Regional Medical Center Hospital, Longview, TX, CCN 450702
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Clinics of Longview Internal Medicine CurrentSince Mar 5, 2012 Accepting new patients
Winnie-Stowell Hospital District Past Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients

Locations

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

707 Hollybrook Dr
Bldg 1
Longview, TX 75605

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

802 Medical Cir
Ste 205
Longview, TX 75605
Phone (903) 291-6209

Interoperability endpoints

  • Direct secure messaging: sanjay.reddy.1@23550.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Treviso Transitional CareLongview, TX, CCN 676368 Skilled nursing facility Adp of the SNF Apr 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1649459595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052410",
            "telephone_number": "903-757-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052410",
            "telephone_number": "903-757-6042",
            "fax_number": "903-291-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SANJAY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D; M.P.H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M8944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "M8944",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.