Jeffshan Sam Jose John Ponnarasu, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5338 Issued in SC

Practice address

316 2ND St
Cheraw, SC 29520-2404

Phone

(843) 921-4851

NPI assigned

Jan 16, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palmetto Family Medicine of Chesterfield County LLCGroup PAC ID 7012807860, 4 clinicians

McLeod Health CherawGroup PAC ID 7911228259, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Health Cheraw Hospital, Cheraw, SC, CCN 420107
• McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjohnponnarasu93275@directmcleodehealth.org
• FHIR API: https://fhir4.healow.com/fhir/r4/HJDHAD/Endpoint/HJDHAD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• McLeod Health Cheraw

  dba McLeod Health Cheraw Physicians

  • Certified Registered Nurse Anesthetist
  • Cheraw, SC
  • NPI 1275912974
  Medicare reassignment Care Compare group
• Palmetto Family Medicine of Chesterfield County, LLC

  • Family Medicine Physician
  • Cheraw, SC
  • NPI 1932291242
  Medicare reassignment Care Compare group
• McLeod Health Cheraw

  dba McLeod Family Medicine - Darlington

  • Rural Health Clinic/Center
  • Darlington, SC
  • NPI 1003410903
  NPD
• Northern Cochise Community Hospital Inc

  • Critical Access Hospital
  • Willcox, AZ
  • NPI 1013060367
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLeod Health Cheraw

  • General Acute Care Hospital
  • Cheraw, SC
  • NPI 1902283740
  Care Compare affiliation
• McLeod Regional Medical Center of the Pee Dee, Inc.

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1699756221
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1003677220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 MALL BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 2ND ST",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295202404",
            "telephone_number": "843-921-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN PONNARASU",
        "first_name": "JEFFSHAN",
        "middle_name": "SAM JOSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Horton Chiropractic Clinic of Cheraw, PA
• Alison Carisa Huggins, NP
• Adeana Hope Hunter
• Sydney M Hutson, LPC
• Kelley Ingram, DPT
• Danielle Johnson
• Tonya Jones, PHARMD
• Carrie Blackman Jordan, D.M.D.
• Anissa F Keith, PTA
• David E Kemmerlin, RPH

• Physician Assistant in Cheraw, SC
• Providers in Cheraw, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.