NPIMap

Organization Active NPI

Jayapal a Reddy MD and Radha T Reddy MD Inc

  • Specialist
  • Rancho Cucamonga, CA
National Provider Identifier
1881937068
Registry record updated Dec 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A89463 Issued in CA
Legal business name
JAYAPAL A REDDY MD AND RADHA T REDDY MD INC
Practice address
9471 Haven Ave
Suite 140
Rancho Cucamonga, CA 91730-5844
Phone
(909) 474-2333
NPI assigned
Apr 5, 2013
Last updated
Dec 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2013

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

Authorized official

Name
Radha Thiruvengadam Reddy, M.D.NPI 1780652073
Title
Secretary
Phone
(909) 561-6627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A89463 CA Primary

Addresses

Primary practice location

9471 Haven Ave
Suite 140
Rancho Cucamonga, CA 91730-5844

Mailing address

9471 Haven Ave
Suite 140
Rancho Cucamonga, CA 91730-5844
Phone (909) 474-2333

Other identifiers 1

IdentifierTypeStateIssuer
00A894630MedicaidCA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 149

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 149

NPI Registry JSON

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388102400000",
    "number": "1881937068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9471 HAVEN AVE",
            "address_2": "SUITE 140",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305844",
            "telephone_number": "909-474-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9471 HAVEN AVE",
            "address_2": "SUITE 140",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305844",
            "telephone_number": "909-474-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYAPAL A REDDY MD AND RADHA T REDDY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-05",
        "last_updated": "2013-12-27",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "RADHA",
        "authorized_official_middle_name": "THIRUVENGADAM",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "909-561-6627",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A89463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A894630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.