Mark Anthony Reddick, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

N1097 Issued in TX

Practice address

5323 Harry Hines Boulevard
House Staff & Gme
Dallas, TX 75390-9257

Phone

(214) 645-8995

NPI assigned

Jun 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Diagnostic RadiologyAlso: Interventional Radiology

Education

Tulane University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates of the Fox Valley SCGroup PAC ID 0446152748, 73 clinicians

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Madison Radiologists S CGroup PAC ID 1951209311, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088
• Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
• Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
• Ascension NE Wisconsin - St Elizabeth Campus Hospital, Appleton, WI, CCN 520009
• Waupun Memorial Hospital Hospital, Waupun, WI, CCN 521327

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Dean Health Systems, Inc

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment Care Compare group NPD
• Madison Radiologists S C

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1871573725
  Medicare reassignment Care Compare group NPD
• Radiology Associates of the Fox Valley, SC

  • Diagnostic Radiology Physician
  • Neenah, WI
  • NPI 1477539443
  Medicare reassignment Care Compare group NPD
• Dean Health Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

• Agnesian Healthcare, Inc

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1346228541
  Care Compare affiliation
• Ascension NE Wisconsin, Inc

  • Ambulatory Surgical Clinic/Center
  • Menasha, WI
  • NPI 1124075536

  Hospital

  Care Compare affiliation
• Ascension NE Wisconsin, Inc

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1407803638
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1740920909
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1497119218
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1689038408
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1831773589
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1902832306
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1912721002
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1912880329
  Care Compare affiliation
• Thedacare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Neenah, WI
  • NPI 1023472842
  Care Compare affiliation
• Thedacare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Menasha, WI
  • NPI 1720434806
  Care Compare affiliation

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1801090832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 845347",
            "address_2": "HOUSE STAFF & GME",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-590-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BOULEVARD",
            "address_2": "HOUSE STAFF & GME",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909257",
            "telephone_number": "214-645-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDICK",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "N1097",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "N1097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP3-0029592",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Denise Redden, APRN-CNP
• Karin Ann Reddert, LMSW-AP
• Stephanie-Louise Reddick-Jessie, RN
• Claire Smith Reddick, M.D.
• Emily Reddick
• Meaghan Redding
• Chanakyaram Ayyadap Reddy, M.D.
• Cristina Paola Reddy, AUD
• Jagadeshwar G Reddy, M.D.
• Jagan S Reddy, MD

• Vascular & Interventional Radiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Vascular & Interventional Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.