Individual provider Active NPI

Sridhar M Reddy, M.D.

  • Interventional Cardiology Physician
  • Sherman Oaks, CA
National Provider Identifier
1669817987
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A167870 Issued in CA
Practice address
4955 Van Nuys Blvd Ste 308
Sherman Oaks, CA 91403-1811
Phone
(818) 528-1260
Fax
(818) 528-1261
NPI assigned
Apr 30, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R74126 AZ
Interventional Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0011X A167870 CA Primary

Addresses

Primary practice location

4955 Van Nuys Blvd Ste 308
Sherman Oaks, CA 91403-1811

Mailing address

13217 Haney PL
Los Angeles, CA 90049-3624
Phone (858) 243-0503

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
I20200727002296 CA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 7113341991 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic CardiologyGroup PAC ID 5799811394, 9 clinicians

Practice addresses (Care Compare)

4955 Van Nuys Blvd
Suite 308
Sherman Oaks, CA 91403-1811
Phone (818) 528-1260

Hospital & facility affiliations

  • Centinela Hospital Medical Center Hospital, Inglewood, CA, CCN 050739
  • Saint Francis Medical Center Hospital, Lynwood, CA, CCN 050104
  • Desert Valley Hospital Hospital, Victorville, CA, CCN 050709
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R74126AZMDInternal Medicine Physician
A167870CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Valley Medical Group, Inc. Single Specialty Current Accepting new patients
Epic Cardiology Single Specialty CurrentSince Jul 1, 2020 Accepting new patients
Southern California Hospitalist Network Medical Group Inc Single Specialty CurrentSince Dec 1, 2022 Accepting new patients
Desert Valley Medical Group, Inc Single Specialty CurrentSince Nov 7, 2022 Accepting new patients
Desert Valley Medical Group, Inc. Internal Medicine CurrentSince Nov 7, 2022 Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Desert Valley Hospital, LLC Past Accepting new patients

Locations

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

3630 E Imperial Hwy
Ste 555B
Lynwood, CA 90262

3630 E Imperial Hwy
Ste 55B
Lynwood, CA 90262
Phone (310) 722-1108

625 The City Dr S
Ste 320
Orange, CA 92868
Phone (714) 202-2330

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

4955 Van Nuys Blvd
Ste 308
Van Nuys, CA 91403
Phone (818) 387-6114

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2754/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1669817987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13217 HANEY PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900493624",
            "telephone_number": "858-243-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 308",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031811",
            "telephone_number": "818-528-1260",
            "fax_number": "818-528-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SRIDHAR",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R74126",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A167870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.