Organization Active NPI

Dr. Ajay Reddy, L.L.C.

  • Internal Medicine Physician
  • Rockville, MD
National Provider Identifier
1871706192
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D53691 Issued in MD
Legal business name
DR. AJAY REDDY, L.L.C.
Practice address
3200 Tower Oaks Blvd
Suite#110
Rockville, MD 20852-4216
Phone
(301) 230-9091
Fax
(301) 230-9091
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Authorized official

Name
Dr. Ajay Reddy, M.D.NPI 1679593685
Title
Owner
Phone
(301) 230-9091

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X D53691 MD Primary

Addresses

Primary practice location

3200 Tower Oaks Blvd
Suite#110
Rockville, MD 20852-4216

Mailing address

3200 Tower Oaks Blvd
Suite#110
Rockville, MD 20852-4216
Phone (301) 230-9091

Other identifiers 1

IdentifierTypeStateIssuer
023103700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091008000375 DC Part B Supplier - Clinic/Group Practice 2264578061 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville, MD; Bethesda, MD

National Provider Directory

National Provider Directory

Locations

3200 Tower Oaks Blvd
Rockville, MD 20852
Phone (301) 593-6554

3200 Tower Oaks Blvd
Ste 110
Rockville, MD 20852
Phone (301) 230-9091

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4329/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1871706192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 TOWER OAKS BLVD",
            "address_2": "SUITE#110",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524216",
            "telephone_number": "301-230-9091",
            "fax_number": "301-230-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 TOWER OAKS BLVD",
            "address_2": "SUITE#110",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524216",
            "telephone_number": "301-230-9091",
            "fax_number": "301-230-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. AJAY REDDY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "AJAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-230-9091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D53691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023103700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.