SHILPA REDDY
NPI 1013367416
Family Medicine in Phillipsburg, NJ

Q: What is Shilpa Reddy's NPI number?

The NPI number for Shilpa Reddy is 1013367416. It was assigned to this individual provider in the NPPES registry on June 16, 2016.

Q: What is Shilpa Reddy's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Shilpa Reddy was last updated on May 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 16, 2016PECOS EnrolledAccepts Medicare Assignment

95.64/100

CMS Quality Rating

200 STRYKERS RD STE 1, PHILLIPSBURG, NJ 08865(908) 847-6568(866) 278-3009 Get Directions Write a Review

NPPES record last updated: May 19, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 19, 2020, Aug 30, 2019, Jun 16, 2016 (3 updates tracked since 2016).

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About Shilpa Reddy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHILPA REDDY (NPI 1013367416) is an individual family medicine provider in Phillipsburg, New Jersey, licensed in New Jersey (25MA10641400) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS, is affiliated with St Luke's Warren Hospital, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1013367416

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSHILPA REDDY

Location Address200 STRYKERS RD STE 1Phillipsburg, NJ 08865-9488

Mailing Address185 Roseberry St, Farley Bldg., 2nd FloorPhillipsburg, NJ 08865-2748 · (908) 847-2621 · Fax (908) 847-3045

Phone(908) 847-6568

Fax(866) 278-3009

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateJune 16, 2016

Last NPPES UpdateMay 19, 20203 updates tracked since enumeration

NPPES CertifiedMay 19, 2020

✔ NPI 1013367416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NJ · 25MA10641400

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

200 STRYKERS RD STE 1, Phillipsburg, NJ 08865

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shilpa Reddy is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517297344

PECOS Enrollment IDI20190923000131

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

480 services285 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

137 services137 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

109 services97 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

50 services49 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

48 services47 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

42 services30 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

37 services29 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

34 services34 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

34 services34 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

32 services26 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

22 services22 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

13 services13 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Luke's Warren Hospital

Acute Care Hospitals · Phillipsburg, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310060

Location185 Roseberry StPhillipsburg, NJ 08865 · Warren County

Emergency services

St Luke's Hospital Bethlehem

Acute Care Hospitals · Bethlehem, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390049

Location801 Ostrum StreetBethlehem, PA 18015 · Northampton County

Emergency services Birthing friendly

St Luke's Hospital - Easton Campus

Acute Care Hospitals · Easton, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390162

Location250 South 21st StreetEaston, PA 18042 · Northampton County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08865 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.64/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.57

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers35 claims66 services$6.10 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNETH LY

Family Medicine

200 STRYKERS RD STE 1
PHILLIPSBURG, NJ 08865

Warren County (908) 847-6568

SONIA SHARMA CRNP

Nurse Practitioner (Family)

200 STRYKERS RD STE 1
PHILLIPSBURG, NJ 08865

Warren County (908) 847-6568

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shilpa Reddy's NPI number?

The NPI number for Shilpa Reddy is 1013367416. It was assigned to this individual provider in the NPPES registry on June 16, 2016.

Where is Shilpa Reddy located?

Shilpa Reddy practices at 200 Strykers Rd Ste 1, Phillipsburg, NJ 08865. The listed phone number is (908) 847-6568.

What is Shilpa Reddy's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shilpa Reddy enrolled in Medicare?

Yes. Shilpa Reddy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shilpa Reddy accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Shilpa Reddy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shilpa Reddy affiliated with any hospitals?

According to CMS data, Shilpa Reddy is affiliated with St Luke's Warren Hospital, St Luke's Hospital Bethlehem and St Luke's Hospital - Easton Campus.

When was this NPI record last updated?

The NPPES record for Shilpa Reddy was last updated on May 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.