Individual provider Active NPI

Deepica Ganta Reddy, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1841262318
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME95186 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME95186 FL
Internal Medicine Physician 207R00000X ME95186 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

10898 Baymeadows Rd Ste 300
Jacksonville, FL 32256-5838
Phone (904) 363-2733

Other identifiers 2

IdentifierTypeStateIssuer
P00790301OtherFLRAILROAD MEDICARE
274831200MedicaidFL

Other names 1

  • Deepica Ganta Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dreddy2020084@ehrdirect.mayoclinicmsg.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
I20060804000263 FL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2668475963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Warren Alpert Medical School of Brown University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
74.85
Promoting interoperability
100
Improvement activities
40
Cost
72.62

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Sep 29, 2023 Accepting new patients
Baptist Primary Care Inc Internal Medicine CurrentSince Dec 1, 2008 Accepting new patients
Baptist Primary Care Inc CurrentSince Dec 1, 2008 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Sep 29, 2023 Accepting new patients

Locations

10898 Baymeadows Rd
Ste 300
Jacksonville, FL 32256
Phone (904) 363-2733

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: dreddy2020084@ehrdirect.mayoclinicmsg.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1841262318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10898 Baymeadows Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322565838",
            "country_code": "US",
            "telephone_number": "904-363-2733",
            "fax_number": "904-363-3484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "DEEPICA",
        "middle_name": "GANTA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME95186",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME95186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00790301",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274831200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dreddy2020084@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DEEPICA",
            "last_name": "GANTA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.