MR. MOHAN ETTYREDDY (MD) – Anesthesiology Physician, NPI 1407807100
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,371 ANESTHESIOLOGY in CA
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Provider Addresses for MR. MOHAN ETTYREDDY (MD)
Stockton Post Office, 401, North San Joaquin Street, Stockton, San Joaquin County, California, 95202, United States
STOCKTON, CA 95267
Phone: (209) 956-7725
Fax: (209) 956-7733
Type: Mailing
Sierra View Medical Center, 465, West Putnam Avenue, Porterville, Tulare County, California, 93257, United States
PORTERVILLE, CA 93257
Phone: (559) 784-1110
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2023-03-06 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-11-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070926000310 | I | Anesthesiology | PA | TBD |
| I20221117002691 | I | Anesthesiology | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 95267)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY | CA | 00790 | Anesthesia for procedure in upper abdomen including use of an endoscope | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | NC | |
| Certified Registered Nurse Anesthetist (Crna) | OH | |
| A N E S T H E S I O L O G Y | OH | |
| Certified Registered Nurse Anesthetist (Crna) | OH | |
| - | KY | |
| Certified Registered Nurse Anesthetist (Crna) | OH | |
| - | OH | |
| Certified Registered Nurse Anesthetist (Crna) | IN | |
| A N E S T H E S I O L O G Y | OH | |
| Certified Registered Nurse Anesthetist (Crna) | OH |
Reviews
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