Individual provider Active NPI

Kuchikula Rajender Reddy, MD

  • Gastroenterology Physician
  • Philadelphia, PA
National Provider Identifier
1992848519
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD073656L Issued in PA
Practice address
3400 Civic Center Blvd
Pcam 4 South
Philadelphia, PA 19104-5127
Phone
(215) 349-8222
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD073656L PA
Transplant Hepatology Physician 207RT0003X MD073656L PA
Gastroenterology Physician 207RG0100X MD073656L PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
Pcam 4 South
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
Pcam 4 South
Philadelphia, PA 19104-5127
Phone (215) 349-8222

Other identifiers 1

IdentifierTypeStateIssuer
0018711540001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100317000425 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 7810022795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 349-8222

554 N Duke Street 3Rd FL
Liver Transplant LGH
Lancaster, PA 17602-2225
Phone (215) 662-4554

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Sep 28, 2001 Accepting new patients
University of Penn-Medical Group Gastroenterology Current Accepting new patients
University of Penn-Medical Group CurrentSince Jun 12, 2017 Accepting new patients
University of Penn - Medical Group Gastroenterology CurrentSince Sep 28, 2001 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

1501 N Cedar Crest Blvd
Ste 110
Allentown, PA 18104
Phone (610) 821-2828

1501 Lansdowne Ave
Fl 1
Darby, PA 19023
Phone (610) 237-2531

554 N Duke St
Fl 3
Lancaster, PA 17602
Phone (717) 544-1960

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

3400 Civic Center Blvd
Fl 4
Philadelphia, PA 19104
Phone (215) 662-3580

3400 Civic Center Blvd
#4
Philadelphia, PA 19104
Phone (215) 614-1618

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

777 Township Line Rd
Yardley, PA 19067
Phone (215) 399-6011

Organizations & group practices 5

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 3

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1992848519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "PCAM 4 SOUTH",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-349-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "PCAM 4 SOUTH",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-349-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "KUCHIKULA",
        "middle_name": "RAJENDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD073656L",
            "primary": false
        },
        {
            "code": "207RT0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": "PA",
            "license": "MD073656L",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD073656L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018711540001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.