Jayakar Reddy Kanmantha Reddy is a Geriatric Medicine (Internal Medicine) Physician practicing in Waterford Township, Michigan. The National Provider Identifier (NPI) is #1629086244, which was assigned on August 3, 2006, and the registration record was last updated on September 11, 2025. The practitioner's main practice location is at 1255 North Oakland Boulevard, Suite 175, Waterford Township, MI 48327; the contact telephone number is 2486662756, and the fax number is 2486662646. The primary taxonomy of Jayakar Reddy Kanmantha Reddy is Geriatric Medicine (Internal Medicine) Physician (207RG0300X), with specialization in Geriatric Medicine. Jayakar Reddy Kanmantha Reddy is licensed to practice in the state of Michigan (#4301068131), Michigan (#4301068131).
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
| NPI | 1629086244 |
| Entity Type | Individual |
| Provider Name | JAYAKAR REDDY KANMANTHA REDDY |
| Gender | Male |
| Credential | MD |
| Practice Address |
1255 North Oakland Boulevard Suite 175 Waterford Township MI 48327 |
| Practice Telephone | 2486662756 |
| Practice Fax Number | 2486662646 |
| Mailing Address |
Po Box 7752 Bloomfield Hills MI 48302-7752 |
| Mailing Telephone | 2486662756 |
| Mailing Fax Number | 2486662646 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2025-09-11 |
| Is Sole Proprietor | N |
| PAC ID |
2365405255 Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID |
| Full Name | JAYAKAR REDDY KANMANTHA REDDY |
| Primary Specialty | INTERNAL MEDICINE |
| Address |
43996 Woodward Ave Bloomfield Hills MI 48302-5028 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 4301068131 | MI | ||
| Y | 207RG0300X | Internal Medicine | Geriatric Medicine | 4301068131 | MI |
| Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| Grouping | Allopathic & Osteopathic Physicians |
| Definition: An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| Classification | Internal Medicine |
| Grouping | Allopathic & Osteopathic Physicians |
| Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Audrey Jean Lowry | 600 W Cermak Rd Ste 3d, Chicago, IL 60616-2268 | Geriatric Medicine (Internal Medicine) Physician | 2025-10-07 |
| Medical Center of Toluca Lake | 10718 Riverside Dr Unit A, North Hollywood, CA 91602-2313 | Geriatric Medicine (Internal Medicine) Physician | 2025-11-03 |
| Jenova Medical, LLC | 810 Cardinal Ln Ste 230, Hartland, WI 53029-2390 | Geriatric Medicine (Internal Medicine) Physician | 2025-09-10 |
| Yvonne Renee Battiste | 1005 E Rosecrans Ave, East Rancho Dominguez, CA 90221-2149 | Geriatric Medicine (Internal Medicine) Physician | 2025-10-20 |
| Baptist Primary Care Inc | 1320 Roberts Dr Ste 105a, Jacksonville Beach, FL 32250-3253 | Geriatric Medicine (Internal Medicine) Physician | 2025-10-09 |
| Johns Hopkins Community Physicians, Inc | 5901 Holabird Ave Ste A, Baltimore, MD 21224-6015 | Geriatric Medicine (Internal Medicine) Physician | 2025-10-21 |
| Dr. Javier Rios, A Medical Corporation | 49865 29 Palms Hwy, Morongo Valley, CA 92256-9776 | Geriatric Medicine (Internal Medicine) Physician | 2025-10-06 |
| Caroline Mawanda P.C | 121 Brick Kiln Rd Ste 216, Chelmsford, MA 01824-3259 | Geriatric Medicine (Internal Medicine) Physician | 2025-09-26 |
| Altea Medical Kansas LLC | 1001 Sw 29th St, Topeka, KS 66611-3202 | Geriatric Medicine (Internal Medicine) Physician | 2025-10-31 |
| Concept Health Clinic LLC | 399 W Campbell Rd Ste 304, Richardson, TX 75080-3620 | Geriatric Medicine (Internal Medicine) Physician | 2025-09-09 |
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| Street Address |
1255 NORTH OAKLAND BOULEVARD SUITE 175 |
| City | WATERFORD TOWNSHIP |
| State | MI |
| Zip Code | 48327 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Ellington Kennedy Hicks II · Ellington K Hicks II | 1255 N Oakland Blvd, Waterford, MI 48327-1545 | Clinical Social Worker | 2018-09-26 |
| Wendy C Switalski | 6650 Highland Road, Suite 110, Waterford, MI 48327 | Audiologist | 2007-01-12 |
| Salashia Jackson | 1255 N Oakland Blvd, Waterford, MI 48327-1545 | Addiction (Substance Use Disorder) Counselor | 2025-06-26 |
| Marshall David Maldaver | 6515 Highland Rd Ste 100, Waterford, MI 48327-1669 | Psychologist | 2006-10-14 |
| Kelly Ann Clark | 2231 Ellery Ave, Waterford, MI 48327-1107 | Behavioral Analyst | 2018-08-16 |
| Samantha Lynn Genette | 1435 N Oakland Blvd, Waterford, MI 48327-1549 | Addiction (Substance Use Disorder) Counselor | 2017-02-17 |
| Zackary Joseph Clor | 7116 Highland Rd, Waterford, MI 48327-1503 | Foot & Ankle Surgery Podiatrist | 2022-04-13 |
| Angelita Renee Torres | 1255 N Oakland Blvd, Waterford, MI 48327-1545 | Addiction (Substance Use Disorder) Counselor | 2025-06-09 |
| Tamara Duff | 5800 Highland Rd, Waterford, MI 48327-1827 | Family Nurse Practitioner | 2017-01-02 |
| Physiotherapy Associates, Inc. | 7180 Highland Rd, Waterford, MI 48327-1505 | Physical Therapy Clinic/Center | 2006-11-15 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Vamsikalyan Reddy Reddy Borra | 911 Bypass Rd, Pikeville, KY 41501-1602 | Student in an Organized Health Care Education/Training Program | 2022-06-03 |
| Ram K Reddy | 7824 Lake Underhill Rd, Suite H, Orlando, FL 32822-8201 | Hospitalist Physician | 2006-05-17 |
| Dheeraj Reddy | 719 Thompson Ln Ste 38500, Nashville, TN 37204-3615 | Student in an Organized Health Care Education/Training Program | 2025-05-01 |
| Sontosh Reddy | 111 Central Ave, Newark, NJ 07102-1909 | Student in an Organized Health Care Education/Training Program | 2025-05-05 |
| Rajadhar Reddy | 188 Hospital Dr Ste 402, Fairhope, AL 36532-2018 | Student in an Organized Health Care Education/Training Program | 2025-04-30 |
| Ashwini Reddy | 4422 3rd Ave, Bronx, NY 10457-2545 | Student in an Organized Health Care Education/Training Program | 2025-04-24 |
| Rishika Reddy | 550 1st Ave, New York, NY 10016-6402 | Student in an Organized Health Care Education/Training Program | 2025-04-10 |
| Ram K Reddy | 132 Franklin Springs St, Royston, GA 30662-4134 | Internal Medicine Physician | 2006-10-16 |
| Meenakshi B. Reddy | 3100 N Central Ave, Phoenix, AZ 85012-2637 | Student in an Organized Health Care Education/Training Program | 2025-04-12 |
| Venu Gopala Reddy Gangireddy | 555 Kitchings Dr, Statesville, NC 28677-3576 | Internal Medicine Physician | 2010-07-14 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |