Suraj Gopal Reddy, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD2007-0565 Issued in NM

Practice address

610 Broadway Blvd NE
Albuquerque, NM 87102-2372

Phone

(505) 225-2500

Fax

(505) 225-2025

NPI assigned

Jun 15, 2007

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

Medicare fee-for-service enrollment

Enrolled in NM

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

Dermatology

Education

University of New Mexico School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology of New Mexico LLCGroup PAC ID 6608209606, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.8 of 100Reported as group

Quality

100

Improvement activities

40

Cost

76.02

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dermatology of New Mexico LLC

  • Clinic/Center
  • Albuquerque, NM
  • NPI 1104468438
  Medicare reassignment Care Compare group NPD Authorized official
• Albuquerque Dermatology Associates, PA

  • Dermatology Physician
  • Albuquerque, NM
  • NPI 1821045329
  Medicare reassignment NPD

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1740485275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-225-2500",
            "fax_number": "505-225-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-225-2500",
            "fax_number": "505-225-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SURAJ",
        "middle_name": "GOPAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NM",
            "license": "MD2007-0565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua L. Reddish, MD
• Ashok Kota Reddy, M.D.
• Gopal Reddy, MD
• Shilpa Gopal Reddy, MD
• Soumya Reddy, MD
• Jordan Paul Redemann, MD
• Redemption
• Latricia Lynelle Redhair
• Nathaniel West Rediske, M.D.
• Miriam I Redleaf, M.D.

• Dermatology Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dermatology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.