NPIMap

Individual provider Active NPI

Preetham Y Reddy, MD

  • Nephrology Physician
  • Rochester Hills, MI
National Provider Identifier
1720059280
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301072073 Issued in MI
Practice address
1701 South Blvd E
Suite 320
Rochester Hills, MI 48307-6122
Phone
(248) 293-3345
Fax
(248) 293-3368
NPI assigned
Jan 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 4301072073 MI Primary

Addresses

Primary practice location

1701 South Blvd E
Suite 320
Rochester Hills, MI 48307-6122

Mailing address

1886 W Auburn Rd
Suite 400
Rochester Hills, MI 48309-3865
Phone (248) 290-3111

Other identifiers 1

IdentifierTypeStateIssuer
4513050MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000559 MI Practitioner - NephrologyPractitioner - Internal Medicine 6901930387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Kidney Consultants PCGroup PAC ID 1052207115, 45 clinicians

Practice addresses (Care Compare)

1701 S Blvd E
Suite 320
Rochester Hills, MI 48307-6117
Phone (248) 290-3345

Hospital & facility affiliations

  • DaVita Troy Dialysis Dialysis facility, Sterling Heights, MI, CCN 232739
  • Fresenius Kidney Care Beaumont Health - Sterling Heights Dialysis facility, Sterling Heights, MI, CCN 232733
  • DaVita Rochester Hills Dialysis Dialysis facility, Rochester Hills, MI, CCN 232628
  • DaVita Bloomfield Hills Home Dialysis Dialysis facility, Bloomfield Hills, MI, CCN 232697
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: preddy19037@direct.acumenmd.com

Organizations & group practices 1

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 9

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1720059280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1886 W AUBURN RD",
            "address_2": "SUITE 400",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093865",
            "telephone_number": "248-290-3111",
            "fax_number": "248-290-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E",
            "address_2": "SUITE 320",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076122",
            "telephone_number": "248-293-3345",
            "fax_number": "248-293-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PREETHAM",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301072073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4513050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.