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Nitya M Reddy

Internal Medicine

Allopathic & Osteopathic Physicians

725 Jesse Jewell Pkwy SE, Gainesville, GA 30501-3834

PECOS Enrollment

This provider is enrolled in PECOS as NITYA REDDY.

Based on the most recent information from CMS, provider Nitya M Reddy is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1245452598
Provider Type
Individual
Full Name
Reddy, Nitya M
Title
Dr.
Credential
MBBS

Gender
Female
Sole Proprietor
No
Enumeration Date
5/3/2007
Last Updated
3/7/2019

Contact Information

Practice Location

725 Jesse Jewell Pkwy SE, Gainesville, GA 30501-3834

(770) 535-0191

(770) 535-0916

Mailing Location

PO Box 658, Gainesville, GA 30503-0658

(770) 718-1122

(770) 535-7445

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 000485 Georgia
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 061151 Georgia

Provider Identifiers

ID	Description	Issuer
ID 01310558	Description Other	Issuer AMERIGROUP Georgia
ID 52318303	Description Other	Issuer BCBS Georgia
ID 515470	Description Other	Issuer WELLCARE Georgia
ID 531391441A	Description Medicaid	Issuer Unlisted Georgia
ID 3422646	Description Other	Issuer CIGNA Georgia

Nitya M Reddy

PECOS Enrollment

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