Physician Compare National (NPI:1174562276)

HEALTHCARE PROVIDER: JAYASANKAR K REDDY MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1174562276
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2062460827
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100728000615
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	REDDY
	Individual professional last name
Provider First Name	JAYASANKAR
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1508 10TH ST
	Group Practice or individual's line 1 address
City	WICHITA FALLS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	763014401
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450010
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNITED REGIONAL HEALTH CARE SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450241
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FAITH COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450584
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WILBARGER GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	451354
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	HAMILTON HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	451341
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	HASKELL MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1174562276)

HEALTHCARE PROVIDER: JAYASANKAR K REDDY MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information