Narayanan Ponnusamy, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C52112 Issued in CA

Practice address

604 Devonwood Rd
Altadena, CA 91001-4018

Phone

(626) 698-6766

Fax

(626) 198-1913

NPI assigned

Mar 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nponnusamy63502@direct.peacehealth.org

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.

• Marion Independent Physicians Association, LLC

  • Family Medicine Physician
  • Marion, OH
  • NPI 1710925045

  Surgery

  NPD (past)

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1043288574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 DEVONWOOD RD",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910014018",
            "telephone_number": "626-698-6766",
            "fax_number": "626-198-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 DEVONWOOD RD",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910014018",
            "telephone_number": "626-698-6766",
            "fax_number": "626-198-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONNUSAMY",
        "first_name": "NARAYANAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C52112",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD27193",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "48033",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "12604",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgar Pineda Jr.
• June Pinkard, RN
• Alan Pires, D.C.
• Miguel Polanco
• Ann Lloyd Pomphrey, PNP
• Precise Comfort
• Eric Franklin Prince
• Monique Elaine Pruitt, PHARM D
• Miesha Quinones
• Suzana Karolina Radich, MFTI

• Surgery Physician in Altadena, CA
• Providers in Altadena, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.