MEDICARE: BHASKER REDDY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	01046775A	IN
2	207R00000X	Internal Medicine Physician	01046775A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	267030VV	OTHER	IN	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000668271	OTHER	IN	ANTHEM PTAN
4	1102234516	OTHER	IN	ANTHEM PTAN

General Provider Information

NPI Number	:	1023005840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHASKER REDDY MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 N RONALD REAGAN PARKWAY
Second Line	:	SUITE 206
City	:	AVON
State	:	IN
Zip	:	46123-6911
Country	:	US
Telephone Number	:	317-272-8050
Fax Number	:	317-272-8051

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	03/04/2025

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Directions to “ BHASKER REDDY MD” Practice Location

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