KALPANA GINUGU REDDY MD
NPI 1609430354
Family Medicine in Middletown, CT

Active since April 29, 2019PECOS EnrolledAccepts Medicare Assignment
97.27/100
CMS Quality Rating
520 SAYBROOK RD STE N100, MIDDLETOWN, CT 06457(860) 358-3130(860) 358-8657 Get Directions Write a Review

NPPES record last updated: September 14, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kalpana Ginugu Reddy Md NPPES

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

KALPANA GINUGU REDDY MD (NPI 1609430354) is an individual family medicine provider in Middletown, Connecticut, licensed in Connecticut (075412) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and is a graduate of Medical College Of Georgia School Of Medicine (2019).

NPPES Registry Identity

NPI1609430354
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKALPANA GINUGU REDDYCredential: MD
Location Address520 SAYBROOK RD STE N100Middletown, CT 06457-4741
Mailing Address28 Crescent StMiddletown, CT 06457-3650 · (860) 358-6000
Fax(860) 358-8657
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2019
Enumeration DateApril 29, 2019
Last NPPES UpdateSeptember 14, 2023
NPPES CertifiedSeptember 14, 2023
NPI 1609430354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in CT · 075412
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.
520 SAYBROOK RD STE N100, Middletown, CT 06457

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

Kalpana Ginugu Reddy Md 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 ID3870826464
PECOS Enrollment IDI20230901002568
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 9

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.
68 services56 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.
65 services52 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
36 services30 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.
32 services32 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.
22 services22 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.
20 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06457 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

97.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.68
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 4

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

Family Medicine
520 SAYBROOK RD STE N100
MIDDLETOWN, CT 06457
Family Medicine
520 SAYBROOK RD STE N100
MIDDLETOWN, CT 06457
Nurse Practitioner (Adult Health)
520 SAYBROOK RD STE N100
MIDDLETOWN, CT 06457
Internal Medicine (Rheumatology)
520 SAYBROOK RD STE N100
MIDDLETOWN, CT 06457

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 Kalpana Reddy's NPI number?

The NPI number for Kalpana Reddy is 1609430354. It was assigned to this individual provider in the NPPES registry on April 29, 2019.

Where is Kalpana Reddy located?

Kalpana Reddy practices at 520 Saybrook Rd Ste N100, Middletown, CT 06457. The listed phone number is (860) 358-3130.

What is Kalpana Reddy's specialty?

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

Is Kalpana Reddy enrolled in Medicare?

Yes. Kalpana 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.

When was this NPI record last updated?

The NPPES record for Kalpana Reddy was last updated on September 14, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.