Individual provider Active NPI

Nagamani P Reddy, MD

  • Child & Adolescent Psychiatry Physician
  • Woodridge, IL
National Provider Identifier
1912978081
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
036075583 Issued in IL
Practice address
3510 Hobson Rd Ste 305
Woodridge, IL 60517-1442
Phone
(630) 515-1050
Fax
(630) 515-1051
NPI assigned
Jan 27, 2006
Last updated
Apr 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 036075583 IL Primary

Addresses

Primary practice location

3510 Hobson Rd Ste 305
Woodridge, IL 60517-1442

Mailing address

3510 Hobson Rd Ste 305
Woodridge, IL 60517-1442
Phone (630) 515-1050

Other identifiers 1

IdentifierTypeStateIssuer
036075583MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040331001306 IL Practitioner - Psychiatry 5496747370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3510 Hobson Rd
Suite 305
Woodridge, IL 60517-1442
Phone (630) 515-1050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sr Psychiatric LTD CurrentSince May 20, 1991 Accepting new patients

Locations

3510 Hobson Rd
Ste 305
Woodridge, IL 60517
Phone (630) 515-1050

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1912978081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 HOBSON RD STE 305",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605171442",
            "telephone_number": "630-515-1050",
            "fax_number": "630-515-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 HOBSON RD STE 305",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605171442",
            "telephone_number": "630-515-1050",
            "fax_number": "630-515-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "NAGAMANI",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036075583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075583",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

Verify at the official NPI Registry.