Individual provider Active NPI

Siddhartha Thammineni Reddy, MD

  • Hematology & Oncology Physician
  • Hackensack, NJ
National Provider Identifier
1902151624
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
25MA12399100 Issued in NJ
Practice address
92 2ND St
Hackensack, NJ 07601-2191
Phone
(551) 996-5900
NPI assigned
Jul 18, 2012
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 25MA12399100 NJ Primary

Addresses

Primary practice location

92 2ND St
Hackensack, NJ 07601-2191

Mailing address

100 1St St Ste 301
Hackensack, NJ 07601-2190
Phone (551) 996-5900

Other names 1

  • Venkata Siddhartha Reddy Thammineni Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20250108002810 NJ Practitioner - Hematology/Oncology 3577879220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

218 A Sunset Rd
Willingboro, NJ 08046-1110
Phone (609) 835-2900

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (844) 346-7222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12399100NJMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Cancer Care Associates LLC Hematology & Oncology CurrentSince Oct 1, 2024 Accepting new patients
Regional Cancer Care Associates LLC Hematology & Oncology CurrentSince Oct 1, 2024 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

92 2nd St
Hackensack, NJ 07601
Phone (551) 996-2210

500 Frank W Burr Blvd
Ste 560
Teaneck, NJ 07666

Interoperability endpoints

  • Direct secure messaging: tvenkata807168@direct.hfhs.org

Organizations & group practices 2

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 5

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1902151624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 1ST ST STE 301",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012190",
            "telephone_number": "551-996-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 2ND ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012191",
            "telephone_number": "551-996-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SIDDHARTHA",
        "middle_name": "THAMMINENI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NJ",
            "license": "25MA12399100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VENKATA",
            "last_name": "THAMMINENI",
            "middle_name": "SIDDHARTHA REDDY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.