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

Dr. Mahidhar Mahasamudram Reddy, MD

Individual provider Internal Medicine Physician · NPI 1114451630

Dr. Mahidhar Mahasamudram Reddy, MD is a Physical Medicine and Rehabilitation in West Orange, New Jersey. Qualified in 2015, 11 years ago. Practices with New Jersey Sports Medicine LLC, a 2-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
11
Licensed in
NJ
In the registry since
2017
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

1199 Pleasant Valley Way
West Orange, NJ 07052-1424
Phone: (973) 830-7694
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 25MA11750000 (NJ)

Record details

NPI number1114451630
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 12, 2017
Last updated in NPPESDecember 7, 2023
Certification dateDecember 3, 2023

Medicare enrollment

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

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Also practisesINTERVENTIONAL PAIN MANAGEMENT, PAIN MANAGEMENT, SPORTS MEDICINE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice New Jersey Sports Medicine Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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