Individual provider Active NPI

Sumathy Reddy, M.D., F.A.A.F.P.

  • Specialist
  • Long Beach, NY
National Provider Identifier
1992871032
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
145530 Issued in NY
Practice address
871 E Park Ave
Long Beach, NY 11561-2709
Phone
(516) 223-3117
Fax
(516) 431-1179
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 145530 NY Primary

Addresses

Primary practice location

871 E Park Ave
Long Beach, NY 11561-2709

Mailing address

573 Barnard Ave
Woodmere, NY 11598-2709
Phone (516) 223-3117

Other identifiers 2

IdentifierTypeStateIssuer
145530OtherNYLICENSE NUMBER
00720829MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050329001419 NY Practitioner - Family Practice 2466408711 Reassigns benefits to 1 organization
Practice locations: Island Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Warwick Rd
Island Park, NY 11558-1433
Phone (516) 223-3117

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gramercy Medical Services P.C. CurrentSince Nov 10, 2018 Accepting new patients
Beach Terrace Care Center Inc Past Accepting new patients

Locations

3010 W 33rd St
Brooklyn, NY 11224
Phone (347) 713-8648

13916 91st Ave
Jamaica, NY 11435
Phone (718) 454-8556

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

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 1

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1992871032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "573 BARNARD AVE",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982709",
            "telephone_number": "516-223-3117",
            "fax_number": "516-431-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612709",
            "telephone_number": "516-223-3117",
            "fax_number": "516-431-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SUMATHY",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.A.F.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "145530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "145530",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00720829",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.