MR. BALI REDDY SODAM MD
NPI 1689787780
Internal Medicine - Nephrology in Lawton, OK

Active since August 16, 2006PECOS EnrolledAccepts Medicare Assignment
4417 W GORE BLVD, SUITE 1, LAWTON, OK 73505(580) 536-5273(580) 357-8500 Get Directions Write a Review

NPPES record last updated: December 8, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Bali Reddy Sodam Md NPPES

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

MR. BALI REDDY SODAM MD (NPI 1689787780) is an individual nephrology provider in Lawton, Oklahoma, licensed in Oklahoma (24723) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1994).

NPPES Registry Identity

NPI1689787780
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameMR. BALI REDDY SODAMCredential: MD
Location Address4417 W GORE BLVD, SUITE 1Lawton, OK 73505-5978
Mailing Address4417 W Gore Blvd, Suite 1Lawton, OK 73505-5978 · (580) 536-5273 · Fax (580) 357-2423
Fax(580) 357-8500
Sole ProprietorYes
Medical School CMSOtherGraduated 1994
Enumeration DateAugust 16, 2006
Last NPPES UpdateDecember 8, 2010
NPI 1689787780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License Licensed in OK · 24723
Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

4417 W GORE BLVD, Lawton, OK 73505

Other Identifiers 3

Medicare UPINI50032OK
Medicaid200074670AOK
Medicare PIN245735102OK

Accepted 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

Mr. Bali Reddy Sodam 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 ID9133134521
PECOS Enrollment IDI20060302000483
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 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, epoetin alfa, (for non-esrd use), 1000 units J0885
Epoetin alfa is a medication injected to help your body produce more red blood cells, improving energy levels and reducing tiredness. It's often used for patients with certain types of anemia. Each injection contains 1000 units of the medicine.
2,420 services11 patients
Established patient office or other outpatient visit, 20-29 minutes 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.
275 services177 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
234 services49 patients
Dialysis services, 1 physician visit per month (20 years or older) 90962
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can’t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.
68 services18 patients
Home dialysis services per month (20 years or older) 90966
Home dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.
67 services13 patients
Established patient office or other outpatient visit, 30-39 minutes 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.
45 services36 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73505 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
$123.06 typical visit price
range $53.00 – $162.61
Typical copayment $30.76 (range $13.25 – $40.65)
Most-billed visit code 99204
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier16 claims1,380 services$0.30 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier18 claims2,100 services$0.01 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers23 claims3,960 services$0.97 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
2 suppliers13 claims13 services$18.97 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
2 suppliers45 claims45 services$12.61 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 17

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

Dermatology
4417 W GORE BLVD, STE 7
LAWTON, OK 73505
Physical Therapist
4417 W GORE BLVD, SUITE 14
LAWTON, OK 73505
Neurological Surgery
4417 W GORE BLVD, SUITE 9
LAWTON, OK 73505
Internal Medicine
4417 W GORE BLVD, SUITE 13
LAWTON, OK 73505
Clinic/Center
4417 W GORE BLVD, SUITE 6
LAWTON, OK 73505
Internal Medicine (Nephrology)
4417 W GORE BLVD, SUITE 1
LAWTON, OK 73505
Obstetrics & Gynecology
4417 W GORE BLVD, STE 3
LAWTON, OK 73505
Internal Medicine (Nephrology)
4417 W GORE BLVD, SUITE 1
LAWTON, OK 73505

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689787780, enumerated as an "individual" on August 16, 2006.

The provider is located at 4417 W GORE BLVD SUITE 1 LAWTON, OK 73505 and the phone number is (580) 536-5273.

Internal Medicine with taxonomy code 207RN0300X and a focus in Nephrology.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.