Individual provider Active NPI

Prathima Kapadi Basava Reddy, M. D.

  • Hospitalist Physician
  • Chicago, IL
National Provider Identifier
1710118278
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
E-7615 Issued in AR
Practice address
836 W Wellington Ave
Advocate Illinois Masonic Medical Center
Chicago, IL 60657-5147
Phone
(501) 352-9983
NPI assigned
Jul 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60610289 WA
Internal Medicine Physician 207R00000X E-7615 AR
Student in an Organized Health Care Education/Training Program 390200000X 125056499 IL
Hospitalist Physician 208M00000X E-7615 AR Primary

Addresses

Primary practice location

836 W Wellington Ave
Advocate Illinois Masonic Medical Center
Chicago, IL 60657-5147

Mailing address

856 W Nelson St
Apt. 701
Chicago, IL 60657-5152
Phone (501) 352-9983

Other identifiers 1

IdentifierTypeStateIssuer
E-7615OtherARARKANSAS STATE MEDICAL BOARD LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160316000286 WA Practitioner - HospitalistPractitioner - Internal Medicine 7810145612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 944-7977

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60610289WAMDInternal Medicine Physician
125056499ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Internal Medicine CurrentSince Apr 1, 2019 Accepting new patients
Franciscan Medical Group Current Accepting new patients
St Francis Community Hospital Past Accepting new patients

Locations

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

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 3

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": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1710118278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 W NELSON ST",
            "address_2": "APT. 701",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575152",
            "telephone_number": "501-352-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "address_2": "ADVOCATE ILLINOIS MASONIC MEDICAL CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "501-352-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PRATHIMA",
        "middle_name": "KAPADI BASAVA",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-31",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60610289",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-7615",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125056499",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-7615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE MEDICAL BOARD LICENSE",
            "identifier": "E-7615",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.