Active NPI
Madireddy V Subbareddy, MD
- Urology Physician
- Flushing, NY
National Provider Identifier
1902824899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 112106
- Practice address
- 14015 Sanford Ave
Flushing, NY 11355-2557 - Phone
- (718) 670-6400
- Fax
- (718) 640-6479
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 112106 | NY | Primary |
Addresses
Primary practice location
14015 Sanford Ave
Flushing, NY 11355-2557
Mailing address
1000 Zeckendorf Blvd
Garden City, NY 11530-2133
Phone (516) 542-6880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00202584 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112106 | NY | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Qlimg Rochdale Village OB/GYN Office | Urology | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902824899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 ZECKENDORF BLVD",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115302133",
"telephone_number": "516-542-6880",
"fax_number": "516-542-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14015 SANFORD AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113552557",
"telephone_number": "718-670-6400",
"fax_number": "718-640-6479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUBBAREDDY",
"first_name": "MADIREDDY",
"middle_name": "V",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "112106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00202584",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.