NPIMap

Individual provider Active NPI

Matta Temujin Reddy, MD

  • Hospitalist Physician
  • Lexington, SC
National Provider Identifier
1992264121
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
88503 Issued in SC
Practice address
108 Heddon Dr
Lexington, SC 29072-2457
Phone
(484) 560-3506
Fax
(878) 201-9145
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 88503 SC Primary
Family Medicine Physician 207Q00000X 88503 SC
Family Medicine Physician 207Q00000X MD88503 SC
Family Medicine Physician 207Q00000X 88503 RI

Addresses

Primary practice location

108 Heddon Dr
Lexington, SC 29072-2457

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

Taylor At Marion Street
Columbia, SC 29220-9078
Phone (803) 434-6771

Other names 1

  • Dr. Temujin Reddy Matta Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220906003015 SC Practitioner - Family PracticePractitioner - Hospitalist 7416331723 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Georgia PCGroup PAC ID 2961483607, 252 clinicians
Aiken Professional Association LLCGroup PAC ID 0446430805, 55 clinicians
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

302 University Pkwy
Aiken, SC 29801-6302
Phone (803) 641-5000

4211 Trolley Line Rd
Aiken, SC 29801-2749
Phone (803) 306-7733

Taylor at Marion St
Columbia, SC 29220-0001
Phone (803) 296-5579

Hospital & facility affiliations

  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Aiken Regional Medical Center Hospital, Aiken, SC, CCN 420082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
88503RIMDFamily Medicine Physician
MD88503SCMDFamily Medicine Physician
88503SCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Sep 6, 2022 Accepting new patients
Prisma Health Medical Group-Midlands Family Medicine CurrentSince Sep 6, 2022 Accepting new patients
Aiken Professional Association LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Prisma Health Medical Group-Midlands Family Medicine Current Accepting new patients
Cogent Healthcare of Georgia PC Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Aiken Professional Association, LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Vrcare.LLC CurrentSince Mar 12, 2024 Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine Past Accepting new patients
Geisinger Clinic Hospitalist Past Accepting new patients

Locations

4211 Trolley Line Rd
Aiken, SC 29801
Phone (803) 306-7733

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589

Taylor At Marion St
Columbia, SC 29220
Phone (803) 296-3097

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

115 N Sumter St
Ste 110
Sumter, SC 29150
Phone (803) 774-5249

129 N Washington St
Sumter, SC 29150
Phone (803) 774-1752

Interoperability endpoints

  • Direct secure messaging: mreddy598762@direct.ghs.myhfn.org

Organizations & group practices 9

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1992264121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 HEDDON DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722457",
            "telephone_number": "484-560-3506",
            "fax_number": "878-201-9145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Taylor At Marion Street",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292209078",
            "country_code": "US",
            "telephone_number": "803-434-6771",
            "fax_number": "803-434-3955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "MATTA",
        "middle_name": "TEMUJIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "88503",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "88503",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "MD88503",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "88503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEMUJIN",
            "last_name": "MATTA",
            "middle_name": "REDDY",
            "prefix": "DR.",
            "credential": "MBBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.