Individual provider Active NPI

Srikanth Kottapally Reddy, MD

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Tulsa, OK
National Provider Identifier
1912934100
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
2073307 Issued in OK
Practice address
4812 S 109TH East Ave
Suite 300
Tulsa, OK 74146-5826
Phone
(918) 392-1400
Fax
(918) 236-4587
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 2073307 OK Primary

Addresses

Primary practice location

4812 S 109TH East Ave
Suite 300
Tulsa, OK 74146-5826

Mailing address

4802 S 109TH East Ave
Tulsa, OK 74146-5822
Phone (918) 392-1400

Other identifiers 3

IdentifierTypeStateIssuer
250012255OtherOKRAILROAD MEDICARE
P00216400OtherOKRAILROAD MEDICARE
100173420CMedicaidOK

Other names 1

  • Sri K Reddy Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040922000676 OK Practitioner - Physical Medicine and Rehabilitation 7214905702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Bone and Joint Associates PCGroup PAC ID 9335033802, 91 clinicians

Practice addresses (Care Compare)

4812 S 109TH E Ave
Tulsa, OK 74146-5826
Phone (918) 392-1513

Hospital & facility affiliations

  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
61.03
Promoting interoperability
99
Improvement activities
40
Cost
77.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2073307OKMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Bone & Joint Associates PC CurrentSince Feb 15, 2005 Accepting new patients
Osu Health System Anesthesia Past Accepting new patients
State of Oklahoma Past Accepting new patients
Dr Ashok Kache MD Inc Past Accepting new patients
Ahs Oklahoma Physician Group LLC Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

4812 S 109th East Ave
Ste 300
Tulsa, OK 74146
Phone (918) 236-4580

4812 S 109th East Ave
Fl 3
Tulsa, OK 74146

4802 S 109th East Ave
Tulsa, OK 74146
Phone (918) 392-1513

4812 S 109th East Ave
Tulsa, OK 74146
Phone (918) 392-1482

Interoperability endpoints

  • Direct secure messaging: sreddy274935@direct.saintfrancis.com
  • Direct secure messaging: srikanth.reddy@direct.stjohnhealthsystem.com
  • Direct secure messaging: sri.reddy@tbja.gwaydirect.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1601

Organizations & group practices 6

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 2

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1912934100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 S 109TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465822",
            "telephone_number": "918-392-1400",
            "fax_number": "918-392-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 S 109TH EAST AVE",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465826",
            "telephone_number": "918-392-1400",
            "fax_number": "918-236-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SRIKANTH",
        "middle_name": "KOTTAPALLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "OK",
            "license": "2073307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "250012255",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00216400",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100173420C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SRI",
            "last_name": "REDDY",
            "middle_name": "K",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.