NPIMap

Individual provider Active NPI

Sridhar Kadumpalli Reddy, M.D.

  • Nephrology Physician
  • Garden Grove, CA
National Provider Identifier
1780835447
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A118770 Issued in CA
Practice address
12665 Garden Grove Blvd Ste 211
Garden Grove, CA 92843-1916
Phone
(714) 636-2890
NPI assigned
Sep 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 A118770 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd Ste 211
Garden Grove, CA 92843-1916

Mailing address

3401 N Broad St
Internal Medicine Residency Office
Philadelphia, PA 19140-5103
Phone (215) 707-3397

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
I20120820001122 CA Practitioner - Nephrology 9234386665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Wisconsin School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Kidney Consultants IncGroup PAC ID 6103811286, 21 clinicians

Practice addresses (Care Compare)

12665 Garden Grove Blvd
Suite 211
Garden Grove, CA 92843-1916
Phone (714) 636-2890

Hospital & facility affiliations

  • DaVita Crossroads Dialysis Center Dialysis facility, Fullerton, CA, CCN 552544
  • SRS-La Habra Dialysis Dialysis facility, La Habra, CA, CCN 552852
  • DaVita Chapman Home Training Dialysis facility, Fullerton, CA, CCN 752523
  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118770CAMDSocial Worker
A118770CAMDNephrology Physician

Practice roles (12 of 13)

OrganizationSpecialtyStatusNew patients
Southern California Kidney Consultants Inc. Nephrology CurrentSince Jul 1, 2012 Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Southwestern Medical Center, LLC Past Accepting new patients
Alta Newport Hospital, LLC Past Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
St. Joseph Hospital Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Chapman Medical Center Inc Past Accepting new patients
University of California Irvine Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients

Locations

100 E Valencia Mesa Dr
Ste 217
Fullerton, CA 92835
Phone (714) 525-7177

100 E Valencia Mesa Dr
Ste 100
Fullerton, CA 92835
Phone (714) 525-4185

12665 Garden Grove Blvd
Ste 211
Garden Grove, CA 92843
Phone (714) 636-2890

5451 La Palma Ave
Ste 47
La Palma, CA 90623
Phone (714) 226-0818

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21072/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sridhar.reddy.1@21072.direct.athenahealth.com

Organizations & group practices 12

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": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1780835447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "address_2": "INTERNAL MEDICINE RESIDENCY OFFICE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 211",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431916",
            "telephone_number": "714-636-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SRIDHAR",
        "middle_name": "KADUMPALLI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A118770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.