NPIMap

Individual provider Active NPI

Jakkidi S Reddy, MD

  • Internal Medicine Physician
  • Roseville, CA
National Provider Identifier
1780760421
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A75936 Issued in CA
Practice address
588 N Sunrise Ave
Suite 120
Roseville, CA 95661-2842
Phone
(916) 781-9885
Fax
(916) 781-7923
NPI assigned
Oct 27, 2006
Last updated
Jul 12, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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 A75936 CA Primary

Addresses

Primary practice location

588 N Sunrise Ave
Suite 120
Roseville, CA 95661-2842

Mailing address

588 N Sunrise Ave
Suite 120
Roseville, CA 95661-2842
Phone (916) 781-9885

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
I20070317000089 CA Practitioner - Internal Medicine 5799888459 Practice locations: Roseville, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

588 N Sunrise Ave
Suite 120
Roseville, CA 95661-2843
Phone (916) 781-9885

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.25 of 100Reported as individual
Quality
68.37
Improvement activities
40
Cost
79.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75936CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rosanne J Hooks MD PA Past Accepting new patients
Rosanne J Hooks MD PA Past Accepting new patients
Berman Skin Institute Medical Group Inc PastSince Nov 1, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jreddy44025@hisp.ehr.sutterhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1780760421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 N SUNRISE AVE",
            "address_2": "SUITE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612842",
            "telephone_number": "916-781-9885",
            "fax_number": "916-781-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 N SUNRISE AVE",
            "address_2": "SUITE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612842",
            "telephone_number": "916-781-9885",
            "fax_number": "916-781-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "JAKKIDI",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A75936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.