KOTESHWAREDDY VADAGANDLA (M.D) – Internal Medicine Physician, NPI 1154053395

KOTESHWAREDDY VADAGANDLA (M.D) is a healthcare provider. based in East norriton, Pennsylvania. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D. They hold a License No. MT225420 (PA). The NPI Number for KOTESHWAREDDY VADAGANDLA (M.D) is 1154053395

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
KOTESHWAREDDY VADAGANDLA (M.D)
NPI
1154053395
Phone
(610) 278-2003
Address
2701 DEKALB PIKE, GRADUATE MEDICAL EDUCATION OFFICE
Enumeration Date
27 June 2022
Last Update Date
26 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8655608423
Graduation Year
2012 (14 years ago)
PAC ID
7416461124
Group Practice PAC ID
1153414503
Professional Enrollment ID
I20250707000836
Address ID
TX768018520BR1501XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness85
Years active:3State licenses:3Digital endpointsOther names

9,962 INTERNAL MEDICINE in PA

Provider Addresses for KOTESHWAREDDY VADAGANDLA (M.D)

  • 2701 DEKALB PIKE, GRADUATE MEDICAL EDUCATION OFFICE

    EAST NORRITON, PA 19401

    Phone: (610) 278-2003

    Type: Location

  • 1100 BUTTE ST

    REDDING, CA 960010852

    Phone: (530) 244-8250

    Fax: (530) 244-5494

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $83.

Total Amount is formed as General ($83) + Research ($0) + Ownership ($0) = $83.

Last reported payment date: 2023-11-30 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($70).

Total Amount

$83

General + Research + Ownership

Payments

2

Total payment records

General Amount

$83

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2025-07-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250707000836IInternal MedicineTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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 19401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153414503View full group profile
NameSpecialtyState
Internal MedicineNM
Internal Medicine, Emergency MedicineTX
Physician AssistantTX
Internal MedicineTX
Internal MedicineNC
Internal MedicineNV
Family Practice, Internal MedicineTX
Nephrology, Emergency Medicine, Internal MedicineTX
Nephrology, Internal MedicineOK
Internal MedicineNM

Reviews

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Frequently asked questions

What is the 10-digit NPI for KOTESHWAREDDY VADAGANDLA (M.D)?
KOTESHWAREDDY VADAGANDLA (M.D) — NPI 1154053395 — is the standard way to identify this listing.
Is KOTESHWAREDDY VADAGANDLA (M.D) listed as active for patients and plans?
The listing shows KOTESHWAREDDY VADAGANDLA (M.D) as active in the NPI system.
What taxonomy line describes KOTESHWAREDDY VADAGANDLA (M.D)?
For research purposes, treat KOTESHWAREDDY VADAGANDLA (M.D) as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is KOTESHWAREDDY VADAGANDLA (M.D) based?
KOTESHWAREDDY VADAGANDLA (M.D) is tied to East Norriton, Pennsylvania in the data we show; additional addresses may exist on the full record.
Is the information about KOTESHWAREDDY VADAGANDLA (M.D) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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