Individual provider Active NPI

Jagan S Reddy, MD

  • Child & Adolescent Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1811031172
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
G1756 Issued in TX
Practice address
1380 River Bend Dr
Dallas, TX 75247-4914
Phone
(214) 743-1200
Fax
(214) 689-6482
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G1756 TX
Child & Adolescent Psychiatry Physician 2084P0804X G1756 TX Primary

Addresses

Primary practice location

1380 River Bend Dr
Dallas, TX 75247-4914

Mailing address

3712 Lake Powell Dr
Arlington, TX 76016-4159
Phone (817) 572-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110111000721 TX Practitioner - Psychiatry 9032308705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75.31 of 100Reported as group
Quality
56.91
Promoting interoperability
52
Improvement activities
40
Cost
84.11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Mental Health & Mental Retardation Center Psychiatry CurrentSince Jul 7, 2003 Accepting new patients

Locations

1345 River Bend Dr
Ste 200
Dallas, TX 75247
Phone (214) 743-1201

3242 Remond Dr
Dallas, TX 75211

1353 N Westmoreland Rd
Dallas, TX 75211
Phone (214) 333-7015

1380 River Bend Dr
Dallas, TX 75247
Phone (214) 743-1272

1881 Sylvan Ave
Ste 150
Dallas, TX 75208
Phone (214) 331-0107

1881 Sylvan Ave
Ste 200
Dallas, TX 75208
Phone (214) 331-0107

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1811031172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 LAKE POWELL DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760164159",
            "telephone_number": "817-572-5111",
            "fax_number": "214-331-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474914",
            "telephone_number": "214-743-1200",
            "fax_number": "214-689-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "JAGAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "G1756",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "G1756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.