Mandeep Gogia Reddy, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A117051 Issued in CA

Practice address

101 E Valencia Mesa Dr
Fullerton, CA 92835

Phone

(714) 397-5110

NPI assigned

Aug 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Psychiatry

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bridge Telehealth PCGroup PAC ID 4082097613, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bridge Telehealth PC

  • Psychiatry Physician
  • Fullerton, CA
  • NPI 1275266264
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Jude Hospital Inc

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  Care Compare affiliation
• St Jude Hospital Inc

  • General Acute Care Hospital
  • Brea, CA
  • NPI 1891904942
  Care Compare affiliation

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1972796563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4199 CAMPUS DR",
            "address_2": "STE 550",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926124694",
            "telephone_number": "714-397-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E VALENCIA MESA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92835",
            "telephone_number": "714-397-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MANDEEP",
        "middle_name": "GOGIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2022-10-20",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MT191674",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A117051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca S Allan
• Bradley Reber, M.D.
• Rebound Support Group LLC
• Reclaiming Eros a Marriage and Family Therapy Corporation
• Redan Medical Inc
• Pavani Naini Reddy, MD
• Matthew Redfern, PTA
• Holly Ellen Redman, RN, RNFA
• Renee Monique Cheree Reed
• Vetosa Reed

• Psychiatry Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.