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DR. PRATHIMA LANKALA REDDY M.D.
NPI 1457418816
Internal Medicine in Forest Park, GA

Active since January 03, 2007PECOS EnrolledAccepts Medicare Assignment
90.8/100
CMS Quality Rating
1019 ASTOR AVE, FOREST PARK, GA 30297(404) 366-9311(404) 366-1250 Get Directions Write a Review

NPPES record last updated: September 3, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Prathima Lankala Reddy M.d. NPPES

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

DR. PRATHIMA LANKALA REDDY M.D. (NPI 1457418816) is an individual internal medicine provider in Forest Park, Georgia, licensed in Georgia (047649) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, is affiliated with Southern Regional Medical Center, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1457418816
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. PRATHIMA LANKALA REDDYCredential: M.D.
Location Address1019 ASTOR AVEForest Park, GA 30297-3532
Mailing Address2727 Paces Ferry Rd Se Ste 1-1100Atlanta, GA 30339-6151
Phone(404) 366-9311
Fax(404) 366-1250
Sole ProprietorNo
Medical School CMSOtherGraduated 1982
Enumeration DateJanuary 3, 2007
Last NPPES UpdateSeptember 3, 2019
✔ NPI 1457418816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 047649
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.
1019 ASTOR AVE, Forest Park, GA 30297
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Other Identifiers 1

Medicaid000901788AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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

Dr. Prathima Lankala Reddy M.d. 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 ID8628261724
PECOS Enrollment IDI20101021000680
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 10

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.
374 services156 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.
168 services101 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.
79 services79 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.
76 services76 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.
68 services68 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
38 services30 patients

Hospital Affiliations CMS Care Compare 3

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

Southern Regional Medical Center

Acute Care Hospitals · Riverdale, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110165
Location11 Upper Riverdale Road, SWRiverdale, GA 30274 · Clayton County
Emergency services Birthing friendly

Piedmont Henry Hospital

Acute Care Hospitals · Stockbridge, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110191
Location1133 Eagle's Landing ParkwayStockbridge, GA 30281 · Henry County
Emergency services Birthing friendly

Piedmont Fayette Hospital

Acute Care Hospitals · Fayetteville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110215
Location1255 Highway 54 WestFayetteville, GA 30214 · Fayette County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30297 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

90.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities20

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
4%303 patients1/55-star benchmark: 100%
Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
5%38 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
61%227 patients3/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
5%64 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
91%311 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
96%393 patients4/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
93%356 patients4/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
42%171 patients2/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 6

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
11 suppliers37 claims66 services$5.88 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers24 claims26 services$1.08 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers17 claims17 services$61.60 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$29.07 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
1 supplier15 claims930 services$0.03 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers16 claims16 services$18.66 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.

FOREST PARK MEDICAL GROUP
Internal Medicine
1019 ASTOR AVE
FOREST PARK, GA 30297
Clayton County (404) 366-9311
DR. THIRUVANNATHAPUR N KRISHNAMOORTHY M.D.
Internal Medicine
1019 ASTOR AVE
FOREST PARK, GA 30297
Clayton County (404) 366-9311

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 Prathima Reddy's NPI number?

The NPI number for Prathima Reddy is 1457418816. It was assigned to this individual provider in the NPPES registry on January 3, 2007.

Where is Prathima Reddy located?

Prathima Reddy practices at 1019 Astor Ave, Forest Park, GA 30297. The listed phone number is (404) 366-9311.

What is Prathima Reddy's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prathima Reddy enrolled in Medicare?

Yes. Prathima 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 Prathima Reddy accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Prathima 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 Prathima Reddy affiliated with any hospitals?

According to CMS data, Prathima Reddy is affiliated with Southern Regional Medical Center, Piedmont Henry Hospital and Piedmont Fayette Hospital.

When was this NPI record last updated?

The NPPES record for Prathima Reddy was last updated on September 3, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.