Prabhaker Nallu Reddy, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301034415 Issued in MI

Practice address

43331 Commons Dr
Clinton Township, MI 48038-1109

Phone

(586) 263-5410

Fax

(586) 263-7131

NPI assigned

Dec 7, 2006

Last updated

Aug 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: preddy13228@direct.hfhs.org

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.

• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD (past)
• Surgical Associates of Macomb, PLC

  • Surgery Physician
  • Clinton Township, MI
  • NPI 1316031339
  NPD (past)

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1659430437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43331 COMMONS DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-263-5410",
            "fax_number": "586-263-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43331 COMMONS DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-263-5410",
            "fax_number": "586-263-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PRABHAKER",
        "middle_name": "NALLU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301034415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3426512",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1316031339",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lina Rayes Yousif, D.O.
• Natalie Rose Rea-Michalak, LLP, LLMSW
• Sharquisha Reardon, BEHAVIOR TECHNICIAN
• Sydney Marie Rebant
• Talia Rose Rebottaro, OTRL
• Caroline Mae Redman
• Reemmer Chiropractic P.C.
• Dennis Reemmer, DC
• Tracy Reetz
• Wael Refai, MD

• Surgery Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.