Individual provider Active NPI

Tejesh Srinivasa Reddy

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1922312636
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TEP-6365 Issued in NE
Practice address
601 N 30TH St
Suite 1609
Omaha, NE 68131-2137
Phone
(402) 280-5250
Fax
(402) 449-5641
NPI assigned
Aug 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TEP-6365 NE Primary

Addresses

Primary practice location

601 N 30TH St
Suite 1609
Omaha, NE 68131-2137

Mailing address

601 N 30TH St
Suite 1609
Omaha, NE 68131-2137
Phone (402) 280-5250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130916000078 OR Practitioner - Family Practice 3476797366 Reassigns benefits to 1 organization
I20230901000050 FL Practitioner - Internal Medicine 3476797366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of Florida VI LLCGroup PAC ID 1759802333, 141 clinicians

Practice addresses (Care Compare)

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 771-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEP-6365NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Jacksonville, LLC Family Medicine CurrentSince Jun 1, 2023 Accepting new patients
Apogee Medical Group PC CurrentSince Jul 22, 2013 Accepting new patients
Apogee Medical Group PC Current Accepting new patients
Sound Physicians of Florida VI LLC Family Medicine CurrentSince Feb 1, 2025 Accepting new patients
Cogent Healthcare of Jacksonville, LLC CurrentSince Jun 1, 2023 Accepting new patients
Apogee Medical Group PC CurrentSince Jul 22, 2013 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Interoperability endpoints

  • Direct secure messaging: treddy639868@direct.shands.ufl.edu

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": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1922312636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N 30TH ST",
            "address_2": "SUITE 1609",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312137",
            "telephone_number": "402-280-5250",
            "fax_number": "402-449-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 30TH ST",
            "address_2": "SUITE 1609",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312137",
            "telephone_number": "402-280-5250",
            "fax_number": "402-449-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRINIVASA REDDY",
        "first_name": "TEJESH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "TEP-6365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.