Raghunath K Reddy, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A492550 Issued in CA

Practice address

1805 N California St
Suite # 102
Stockton, CA 95204-6037

Phone

(209) 946-4000

Fax

(209) 946-4002

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 1983

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Home Care Services Home health agency, Lodi, CA, CCN 057278
• St Joseph's Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

Merit-based Incentive Payment System (MIPS)

Final score

23.92 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

79.74

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BABDCD/Endpoint/BABDCD

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.

• Stockton Primary Care

  • Primary Care Clinic/Center
  • Lodi, CA
  • NPI 1669743274
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Port City Operating Company, LLC

  dba St. Joseph's Medical Center of Stockton

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation
• Western Health Resources

  dba Adventist Health Home Care Services

  • Home Health Agency
  • Lodi, CA
  • NPI 1770042103
  Care Compare affiliation

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1689775819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST",
            "address_2": "SUITE # 102",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046037",
            "telephone_number": "209-946-4000",
            "fax_number": "209-946-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST",
            "address_2": "SUITE # 102",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046037",
            "telephone_number": "209-946-4000",
            "fax_number": "209-946-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "RAGHUNATH",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A492550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A492550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Reddell
• Amanda Redding
• Joseph A Redding, M.D.
• Ashley Reddy
• Kalsha Reddy, OD
• Darlene Moeun Redick
• Redirection Community Outreach Inc,.
• Diane Redmon, MFT INTERN
• Sheryl Sobrepena Redoblado
• Benjamin Kendall Reece, CCC-SLP

• Family Medicine Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.