Individual provider Active NPI

Kiran Kumar Dhanireddy, M.D.

  • Transplant Surgery Physician
  • Tampa, FL
National Provider Identifier
1821257668
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
ME136464 Issued in FL
Practice address
409 Bayshore Blvd
Tampa, FL 33606
Phone
(813) 844-5544
NPI assigned
Jun 6, 2008
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X A103967 CA
Transplant Surgery Physician 204F00000X ME136464 FL Primary
Surgery Physician 208600000X A103967 CA

Addresses

Primary practice location

409 Bayshore Blvd
Tampa, FL 33606

Mailing address

PO Box 1289
Tampa, FL 33601-1289
Phone (813) 844-7000

Other identifiers 1

IdentifierTypeStateIssuer
025040200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kdhanireddy145734@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181205000088 FL Practitioner - General Surgery 6507928058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Georgetown University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa General Medical Group IncGroup PAC ID 7416253828, 353 clinicians

Practice addresses (Care Compare)

409 Bayshore Blvd
Tampa, FL 33606-2707
Phone (813) 844-9302

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103967CAMDGeneral Practice Dentistry
ME136464FLMDTransplant Surgery Physician
A103967CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Medical Group Inc Surgery CurrentSince Jul 9, 2018 Accepting new patients
Tampa General Hospital Current Accepting new patients
Tampa General Medical Group Inc CurrentSince Jul 9, 2018 Accepting new patients

Locations

214 Morrison Rd
Ste 110
Brandon, FL 33511
Phone (800) 844-9302

409 Bayshore Blvd
Tampa, FL 33606
Phone (813) 253-2640

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: kdhanireddy145734@direct.tgh.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 1

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1821257668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-844-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BAYSHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33606",
            "telephone_number": "813-844-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANIREDDY",
        "first_name": "KIRAN",
        "middle_name": "KUMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "CA",
            "license": "A103967",
            "primary": false
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "FL",
            "license": "ME136464",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A103967",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025040200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdhanireddy145734@direct.tgh.org",
            "affiliation": "N",
            "address_1": "409 Bayshore Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.