Organization Active NPI

Nirmala M Reddy, MD

  • Specialist
  • Yonkers, NY
National Provider Identifier
1962522292
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
167789A Issued in NY
Legal business name
NIRMALA M REDDY, MD
Practice address
970 N Broadway
Suite 309
Yonkers, NY 10701-1309
Phone
(914) 968-6935
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Authorized official

Name
Ms. Nirmala Reddy, MD, P.C.NPI 1053453654
Title
Manager
Phone
(914) 968-6935

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 167789A NY Primary

Addresses

Primary practice location

970 N Broadway
Suite 309
Yonkers, NY 10701-1309

Mailing address

207 Sprain Rd
Scarsdale, NY 10583-1206
Phone (914) 968-6935

Other identifiers 1

IdentifierTypeStateIssuer
01189211MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317001243 NY Part B Supplier - Clinic/Group Practice 4688564289 Receives reassigned benefits from 1 practitioner
Practice locations: Yonkers, NY; Scarsdale, NY; Ardsley, NY

National Provider Directory

National Provider Directory

Locations

984 N Broadway
Ste 106
Yonkers, NY 10701

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1962522292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 SPRAIN RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831206",
            "telephone_number": "914-968-6935",
            "fax_number": "914-231-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 N BROADWAY",
            "address_2": "SUITE 309",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011309",
            "telephone_number": "914-968-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIRMALA M REDDY, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "NIRMALA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "914-968-6935",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD, P.C."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "167789A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01189211",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.