Individual provider Active NPI

Sudershan P Reddy, MD

  • Anesthesiology Physician
  • Trenton, NJ
National Provider Identifier
1790791812
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
07847000 Issued in NJ
Practice address
416 Bellevue Ave
Ste 104
Trenton, NJ 08618-4513
Phone
(609) 396-4700
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 9

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 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Healthcare Specialists PC 570 clinicians

Practice addresses (Care Compare)

1 Capital Way
Pennington, NJ 08534-2520
Phone (800) 637-2374

40 Prospect Ave
Hackensack, NJ 07601-1915
Phone (954) 939-5000

901 W Main St
Freehold, NJ 07728-2537
Phone (732) 431-2000

Hospital & facility affiliations

  • Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20060123000375 NJ Practitioner - Anesthesiology 1355239211 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07847000NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jul 1, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 1, 2023 Accepting new patients
Virtua Medical Group, PA Anesthesiology Current Accepting new patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Apr 1, 2014 Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients
Uptown Anesthesia Associates LLP Anesthesiology Past Accepting new patients
Trenton Anesthesiology Associates PA Anesthesiology Past Accepting new patients
Chemung Medical Services PC Past Accepting new patients
Rancocas Anesthesiology, P.a. Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 07847000 NJ Primary

Addresses

Primary practice location

416 Bellevue Ave
Ste 104
Trenton, NJ 08618-4513

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464

Other identifiers 1

IdentifierTypeStateIssuer
0100625MedicaidNJ

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1790791812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 BELLEVUE AVE",
            "address_2": "STE 104",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086184513",
            "telephone_number": "609-396-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SUDERSHAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "07847000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100625",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.