Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ajay Reddivari, MD

Individual provider Cardiovascular Disease Physician · NPI 1063494086

Dr. Ajay Reddivari, MD is an Interventional Cardiology in Kettering, Ohio. Qualified in 1982, 44 years ago. Practices with Kettering Independent Medical Group Inc, a 700-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
44
Licensed in
OH
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1380 E Stroop Rd
Kettering, OH 45429-4926
Phone: (937) 294-4356
Fax: (937) 297-2381
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence 35060503 (OH)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 35-06-0503R (OH)

Record details

NPI number1063494086
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 16, 2005
Last updated in NPPESJanuary 4, 2021
Certification dateJanuary 4, 2021
Mailing address1380 E Stroop Rd, Kettering, OH 45429-4926

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL CARDIOLOGY
Also practisesCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolOTHER
Graduated 1982 (44 years in practice)
Group practice Kettering Independent Medical Group Inc — 700 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Kettering