NPIMap

Individual provider Active NPI

Manjula K Reddy, MD

  • Internal Medicine Physician
  • Modesto, CA
National Provider Identifier
1750306189
Registry record updated Feb 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A93135 Issued in CA
Practice address
730 17TH St
Modesto, CA 95354-1209
Phone
(209) 602-5599
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A93135 CA Primary

Addresses

Primary practice location

730 17TH St
Modesto, CA 95354-1209

Mailing address

PO Box 1648
Pleasanton, CA 94566-0164
Phone (925) 398-8466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060908000280 CA Practitioner - Internal Medicine 5193729937 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalists of Modesto Medical Group IncGroup PAC ID 2567360027, 87 clinicians
Om Medical IncGroup PAC ID 6305076506, 2 clinicians

Practice addresses (Care Compare)

1205 E N St
Manteca, CA 95336-4932
Phone (209) 576-3525

730 17TH St
Modesto, CA 95354-1209
Phone (925) 398-8466

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.77 of 100Reported as group
Quality
46.95
Improvement activities
40
Cost
76.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93135CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalists of Modesto Medical Group Past Accepting new patients
Marin General Hospital Past Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine Past Accepting new patients

Organizations & group practices 5

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 6

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549065600000",
    "number": "1750306189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945660164",
            "telephone_number": "925-398-8466",
            "fax_number": "925-954-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 17TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541209",
            "telephone_number": "209-602-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MANJULA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2019-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A93135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.