Individual provider Active NPI

Sampreet Reddy, MD

  • Dermatology Physician
  • Phoenix, AZ
National Provider Identifier
1992299622
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
66669 Issued in AZ
Practice address
19646 N 27TH Ave Ste 305
Phoenix, AZ 85027-4027
Phone
(480) 556-0446
Fax
(480) 556-0447
NPI assigned
Jun 16, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 66669 AZ
Student in an Organized Health Care Education/Training Program 390200000X 275251 MA
Student in an Organized Health Care Education/Training Program 390200000X BP10065917 TX
Dermatology Physician 207N00000X 66669 AZ Primary

Addresses

Primary practice location

19646 N 27TH Ave Ste 305
Phoenix, AZ 85027-4027

Mailing address

20401 N 73Rd St
Ste 230
Scottsdale, AZ 85255-4153
Phone (480) 556-0446

Other practice location 1

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-7000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220729001980 AZ Practitioner - Dermatology 3577811876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Morehouse School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Lee Averitte Jr PLLCGroup PAC ID 9638069099, 31 clinicians

Practice addresses (Care Compare)

13995 W Statler Blvd
Suite 150
Surprise, AZ 85374-5512
Phone (480) 556-0446

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision69
Removal of skin lesions206
Removal of skin cancer420
Removal or shaving of skin growth40
Skin biopsy34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10065917TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Lee Averitte Jr PLLC Dermatology CurrentSince Aug 1, 2022 Accepting new patients
Richard Lee Averitte Jr., PLLC PastSince Aug 1, 2022 Accepting new patients
Richard Lee Averitte Jr PLLC Dermatology PastSince Oct 22, 2023 Accepting new patients
Richard Lee Averitte Jr., PLLC Past Accepting new patients

Locations

1459 S Higley Rd
Ste 106
Gilbert, AZ 85296
Phone (480) 543-6780

9520 W Palm Ln
Ste 115
Phoenix, AZ 85037

41810 N Venture Dr
Ste D136
Phoenix, AZ 85086
Phone (304) 838-3084

19646 N 27th Ave
Ste 305
Phoenix, AZ 85027

16515 S 40th St
Ste 135
Phoenix, AZ 85048
Phone (480) 231-1240

7331 E Osborn Dr
Ste 330
Scottsdale, AZ 85251
Phone (480) 442-8060

20401 N 73rd St
Ste 230
Scottsdale, AZ 85255

3501 N Scottsdale Rd
Ste 300
Scottsdale, AZ 85251
Phone (480) 949-2080

20401 N 73rd St
Ste 295
Scottsdale, AZ 85255
Phone (480) 538-1333

13995 W Statler Blvd
Ste 150
Surprise, AZ 85374
Phone (805) 560-4464

2127 E Baseline Rd
Ste 104
Tempe, AZ 85283
Phone (480) 897-7070

Interoperability endpoints

  • Direct secure messaging: sreddy@affderm.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1992299622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20401 N 73RD ST",
            "address_2": "STE 230",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554153",
            "telephone_number": "480-556-0446",
            "fax_number": "480-556-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19646 N 27TH AVE STE 305",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274027",
            "telephone_number": "480-556-0446",
            "fax_number": "480-556-0447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155400",
            "country_code": "US",
            "telephone_number": "617-667-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SAMPREET",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-16",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "66669",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "275251",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10065917",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "66669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.