NPIMap

Individual provider Active NPI

Sowmya Reddy Thadisina, MD

  • Family Medicine Physician
  • Medford, MA
National Provider Identifier
1972793370
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
249259 Issued in MA
Practice address
101 Main St Ste 214
Medford, MA 02155-4530
Phone
(781) 391-3885
Fax
(781) 391-6224
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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 249259 MA Primary

Addresses

Primary practice location

101 Main St Ste 214
Medford, MA 02155-4530

Mailing address

101 Main St Ste 214
Medford, MA 02155-4530
Phone (781) 391-3885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191016002489 MA Practitioner - Family PracticePractitioner - Geriatric Medicine 1557531308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

230 Main St
Agawam, MA 01001-1838
Phone (413) 789-6800

Hospital & facility affiliations

  • Elara Caring Home health agency, Braintree, MA, CCN 227475
  • Amedisys Home Health Care Home health agency, Agawam, MA, CCN 227288
  • Baystate Home Health Home health agency, W Springfield, MA, CCN 227011
  • Comfort Plus Caregivers LLC Home health agency, East Longmeadow, MA, CCN 227707
  • Aveanna Healthcare Home health agency, Worcester, MA, CCN 227407
  • Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066
  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077
  • Baystate Noble Hospital Hospital, Westfield, MA, CCN 220065

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc. CurrentSince Jan 3, 2022 Accepting new patients
Hallmark Health Medical Associates Inc Family Medicine CurrentSince Oct 1, 2019 Accepting new patients
Riverbend Medical Group, Inc CurrentSince Jan 3, 2022 Accepting new patients
Mwa,PC Past Accepting new patients

Locations

230 Main St
Agawam, MA 01001
Phone (413) 733-6700

101 Main St
Ste 214
Medford, MA 02155
Phone (781) 391-3532

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Interoperability endpoints

  • Direct secure messaging: sthadisina2389762@direct.trinity-health.org

Organizations & group practices 4

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 11

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": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1972793370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST STE 214",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554530",
            "telephone_number": "781-391-3885",
            "fax_number": "781-391-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST STE 214",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554530",
            "telephone_number": "781-391-3885",
            "fax_number": "781-391-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THADISINA",
        "first_name": "SOWMYA",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "249259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.