Individual provider Active NPI

Nitesh Pymagam Reddy, DO

  • Student in an Organized Health Care Education/Training Program
  • Las Vegas, NV
National Provider Identifier
1659959799
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3014 W Charleston Blvd Ste 130
Las Vegas, NV 89102-0083
Phone
(702) 671-5127
Fax
(702) 671-6440
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3014 W Charleston Blvd Ste 130
Las Vegas, NV 89102-0083

Mailing address

8950 Villa la Jolla Dr Ste C101
La Jolla, CA 92037-1727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251212000333 CA Practitioner - Psychiatry 5991106130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

215 S Hickory St
Escondido, CA 92025-4304

215 S Hickory St
Escondido, CA 92025-4359

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23850CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Sep 14, 2025 Accepting new patients
Neighborhood Healthcare CurrentSince Sep 14, 2025 Accepting new patients
Unlv Medicine PastSince Apr 6, 2021 Accepting new patients

Locations

855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751

425 N Date St
#0
Escondido, CA 92025

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1659959799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE C101",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 W CHARLESTON BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891020083",
            "telephone_number": "702-671-5127",
            "fax_number": "702-671-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "NITESH",
        "middle_name": "PYMAGAM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.