MEDICARE: REDDY CARE PHYSICAL THERAPY PC

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	174400000X	Specialist	0231191	NY

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	113423593	OTHER	NY	PHCS
3	2153187	OTHER	NY	UNITED HEALTHCARE
4	7619	OTHER	NY	CAPITOL
5	9442659	OTHER	NY	CIGNA HEALTHPLANS
6	113423593	OTHER	NY	MULTIPLAN
7	P2540752	OTHER	NY	OXFORD HEALTHPLANS
8	023119	OTHER	NY	VYTRA HEALTHCARE
9	113423593	OTHER	NY	DEVON
10	113423593	OTHER	NY	CORVEL
11	1961313	OTHER	NY	FIRSTHEALTH
12	00000091742	OTHER	NY	BETTERHEALTH
13	QT1321	OTHER	NY	BLUE CROSS BLUE SHIELD
14	168391	OTHER	NY	ELDERPLAN
15	212146D	OTHER	NY	MAGNACARE
16	213410N01	OTHER	NY	HIP HEALTHPLANS
17	080023119NY03	OTHER	NY	ANTHEM HEALTHCARE

General Provider Information

NPI Number	:	1932171097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDDY CARE PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	475 NORTHERN BLVD
Second Line	:	STE 11
City	:	GREAT NECK
State	:	NY
Zip	:	11021-4802
Country	:	US
Telephone Number	:	516-829-0030
Fax Number	:	516-466-7723

Provider Business Practice Location Address
First Line	:	475 NORTHERN BLVD
Second Line	:	STE 11
City	:	GREAT NECK
State	:	NY
Zip	:	11021-4802
Country	:	US
Telephone Number	:	516-829-0030
Fax Number	:	516-466-7723

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	VINOD Y SOMAREDDY
Credential	:	PT, DPT
Telephone Number	:	516-829-0030

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	02/24/2022

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