Individual provider Active NPI

Kalyan Chakravarthy Dadireddy, MD

  • Plastic Surgery Physician
  • Gainesville, FL
National Provider Identifier
1760823595
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME155911 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-0846
Phone
(352) 273-8670
NPI assigned
Jul 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 126832 OH
Plastic Surgery Physician 208200000X 54391 TN
Plastic and Reconstructive Surgery Physician 2086S0122X ME155911 FL
Plastic Surgery Physician 208200000X ME155911 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-0846

Mailing address

PO Box 100138
Gainesville, FL 32610-0138
Phone (352) 273-8670

Other identifiers 4

IdentifierTypeStateIssuer
1760823595MedicaidMO
09037091MedicaidMS
Q030638MedicaidTN
223093001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220409000152 FL Practitioner - Plastic and Reconstructive Surgery 3173898392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Clinical Practice Association IncGroup PAC ID 0345146254, 1,886 clinicians

Practice addresses (Care Compare)

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

3450 Hull Rd
Gainesville, FL 32607-4144

3450 SW Hull Rd
Uf Health Pediatric Urology Osmi
Gainesville, FL 32607-4144
Phone (352) 265-8240

3480 Hull Rd
Gainesville, FL 32607-4144
Phone (352) 338-7100

4037 NW 86TH Ter
FL 3
Gainesville, FL 32606-9277
Phone (352) 265-7777

4037 NW 86TH Terr 2ND Floor
Gainesville, FL 32606-9277

4037 NW 86TH Terr Floor
Gainesville, FL 32606-9277

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

  • Uf Health Shands Hospital Hospital, Gainesville, FL, CCN 100113

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
126832OHMDPlastic Surgery Physician
54391TNMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Apr 4, 2022 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Apr 4, 2022 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

4037 NW 86th Ter
Fl 3
Gainesville, FL 32606
Phone (352) 265-7777

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kdadireddy572211@direct.shands.ufl.edu

Organizations & group practices 2

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 8

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": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1760823595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100138",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100138",
            "telephone_number": "352-273-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100846",
            "telephone_number": "352-273-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADIREDDY",
        "first_name": "KALYAN",
        "middle_name": "CHAKRAVARTHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "126832",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TN",
            "license": "54391",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME155911",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME155911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760823595",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09037091",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q030638",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223093001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.