MR. MADHUSUDAN REDDY (NPI# 1972619146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972619146 |
| Entity Type | Individual |
| Full Name | MR. MADHUSUDAN REDDY |
| Credential | P.A.-C |
| Practice Address |
3300 Webster St Suite 500 Oakland CA 94609-3117 |
| Practice Telephone | 5104656600 |
| Practice Fax Number | 5108390806 |
| Mailing Telephone | 5104656600 |
| Mailing Fax Number | 5108390806 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA 17823 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3300 WEBSTER ST SUITE 500 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073517603 | James K. Mooney | Specialist | 3300 Webster St, Ste 710, Oakland, CA 94609-3117 | 2005-06-10 |
| 1174970461 | Malboubi Dental Corporation | Dentist | 3300 Webster St, Suite 905, Oakland, CA 94609-3117 | 2016-05-17 |
| 1245607456 | Hill Health Inc A Medical Corporation | Family Medicine | 3300 Webster St, Oakland, CA 94609-3117 | 2015-08-24 |
| 1669879714 | Catherine Logan Maier | Registered Nurse | 3300 Webster St, Suite 1200, Oakland, CA 94609-3117 | 2014-12-03 |
| 1124420658 | Brianna Nicole Cosentino | Physical Therapist | 3300 Webster St, 1201, Oakland, CA 94609-3117 | 2014-09-16 |
| 1477966919 | Jessica Tice | Physical Therapist | 3300 Webster St, 703, Oakland, CA 94609-3117 | 2014-06-03 |
| 1205174505 | Kelly Lee Wong | Internal Medicine | 3300 Webster St, 1000, Oakland, CA 94609-3117 | 2013-01-21 |
| 1770885741 | Rachel L Kay | Nurse Practitioner | 3300 Webster St, Suite 304, Oakland, CA 94609-3117 | 2010-11-24 |
| 1306146568 | Carolyn Jacobs Bernstein | Nurse Practitioner | 3300 Webster St, Oakland, CA 94609-3117 | 2010-10-21 |
| 1528378460 | John Alexander Gillean | Psychiatry & Neurology | 3300 Webster St, Suite 402, Oakland, CA 94609-3117 | 2010-10-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
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| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023596095 | Emily Eisenberg | Physician Assistant | 1411 E 31st St, Oakland, CA 94602-1092 | 2018-08-01 |
| 1467975953 | Katherine Burns | Physician Assistant | 365 Hawthorne Ave Ste 101, Oakland, CA 94609-3115 | 2017-07-17 |
| 1770014367 | Ambreen Zaman | Physician Assistant | 3315 Broadway, Street Level, Oakland, CA 94611-5717 | 2017-03-24 |
| 1902253974 | Gina Laura Robinson | Physician Assistant | 275 W Macarthur Blvd, Suite 17, Oakland, CA 94611-5641 | 2016-05-19 |
| 1447592266 | Kimberly Gail Ernest | Physician Assistant | 275 W Macarthur, Oakland, CA 94611-5641 | 2013-03-19 |
| 1720366271 | Scott Andrew Tabish | Physician Assistant | 280 W Macarthur Blvd, Oakland, CA 94611-5642 | 2011-08-02 |
| 1033414131 | Linda Irene Villarreal | Physician Assistant | 275 W Macarthur, Oakland, CA 94611-5641 | 2011-01-20 |
| 1669702205 | Mary Kathryn Rankin | Physician Assistant | 275 W Macarthur, Oakland, CA 94611-5641 | 2010-01-04 |
| 1578796439 | Shawn Charles Lies | Physician Assistant | 3315 Broadway, Oakland, CA 94611-5717 | 2009-08-26 |
| 1831368109 | Patrick J Wong | Physician Assistant | 744 52nd St, Suite 5203, Oakland, CA 94609 | 2008-02-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.