Physician Compare National (NPI:1295763753)

HEALTHCARE PROVIDER: SUDHAKAR REDDY M.D

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

Individual Professional Information
NPI	1295763753
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6002001948
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110829000183
	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	SUDHAKAR
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1967
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DIGESTIVE DISEASES CENTER OF FLORIDA PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0345227328
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	10
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	204 E 19TH ST
	Group Practice or individual's line 1 address
City	PANAMA CITY
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	324054707
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8507635409
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100242
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GULF COAST REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100026
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAY MEDICAL CENTER SACRED HEART HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100313
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SACRED HEART HOSPITAL ON THE GULF
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	101308
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	NORTHWEST FLORIDA COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	101304
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	CALHOUN-LIBERTY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1295763753)

HEALTHCARE PROVIDER: SUDHAKAR REDDY M.D

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information