Individual provider Active NPI

Hitesh Ramesh Reddy, MBBS

  • Trauma Surgery Physician
  • Carbondale, IL
National Provider Identifier
1699338558
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
036173993 Issued in IL
Practice address
305 W Jackson St Ste 206
Carbondale, IL 62901-1474
Phone
(618) 457-3006
Fax
(618) 457-3007
NPI assigned
Apr 17, 2019
Reactivated
Dec 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036173993 IL
Surgical Critical Care Physician 2086S0102X 036173993 IL
Trauma Surgery Physician 2086S0127X 036173993 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

305 W Jackson St Ste 206
Carbondale, IL 62901-1474

Mailing address

Howard University Hospital
2041 Georgia Avenue, NW
Washington, DC 20060

Other practice location 1

317 S 14th St
Herrin, IL 62948-3671
Phone (618) 942-2002

Other practice location 2

Howard University Hospital
2041 Georgia Avenue, NW
Washington, DC 20060
Phone (202) 865-4608

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address hreddy84774@sih.direct-ci.com
Direct Messaging Address hreddy84774@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250819000816 IL Practitioner - General Surgery 7911444708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Illinois Medical Services NFPGroup PAC ID 3678677390, 331 clinicians

Practice addresses (Care Compare)

305 W Jackson St
Suite 206
Carbondale, IL 62901-1474
Phone (618) 457-3006

Hospital & facility affiliations

  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011
  • Harrisburg Medical Center Hospital, Harrisburg, IL, CCN 140210
  • St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036173993ILMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Aug 18, 2025 Accepting new patients
Southern Illinois Medical Services, NFP PastSince Aug 10, 2025 Accepting new patients
Southern Illinois Hospital Services Past Accepting new patients

Locations

305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

317 S 14th St
Herrin, IL 62948
Phone (618) 942-2002

502 W Saint Louis St
Ste 4
West Frankfort, IL 62896
Phone (618) 937-3400

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.

Hospital & facility affiliations 4

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1699338558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HOWARD UNIVERSITY HOSPITAL",
            "address_2": "2041 GEORGIA AVENUE, NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE 206",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-457-3006",
            "fax_number": "618-457-3007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483671",
            "country_code": "US",
            "telephone_number": "618-942-2002",
            "fax_number": "618-988-9780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Howard University Hospital",
            "address_2": "2041 Georgia Avenue, NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20060",
            "country_code": "US",
            "telephone_number": "202-865-4608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "HITESH",
        "middle_name": "RAMESH",
        "name_prefix": "Mr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "deactivation_date": "2019-12-04",
        "reactivation_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036173993",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036173993",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036173993",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hreddy84774@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "317 S 14th St",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hreddy84774@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 206",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.