Punyakam PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28418 Issued in AZ

Legal business name

PUNYAKAM PLLC

Practice address

690 E Warner Rd Ste 133
Gilbert, AZ 85296-3057

Phone

(480) 892-1212

Fax

(480) 892-4941

NPI assigned

Jun 6, 2011

Organization subpart

No

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

Authorized official

Name

Chad Gammage

Title

Ceo

Phone

(480) 892-1212

Specialties & licenses 1

Addresses

Other names 1

• AVISTA Medical Center & Weight Loss Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Punya Raman Gammage, MD

  • Family Medicine Physician
  • Gilbert, AZ
  • NPI 1215907209
  Medicare reassignment NPD
• Shannon Lynn Stark, NP

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1730645763
  Medicare reassignment NPD
• Brian Allen, PA-C

  • Medical Physician Assistant
  • Chandler, AZ
  • NPI 1841269412
  Medicare reassignment
• Abby Michele Nasternak, PA C

  • Medical Physician Assistant
  • Glendale, AZ
  • NPI 1689645467
  NPD (past)

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1073807202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 E WARNER RD STE 133",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963057",
            "telephone_number": "480-892-1212",
            "fax_number": "480-892-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E WARNER RD STE 133",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963057",
            "telephone_number": "480-892-1212",
            "fax_number": "480-892-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUNYAKAM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "GAMMAGE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-892-1212"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "28418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVISTA Medical Center & Weight Loss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trinidad Puentes
• Ian Theodore Puetz, D.C.
• Kelly Pugh, MD
• Kathryn Pugmire
• Rebecca Ann Pukpumin, SLP
• Sirisha Puppala, MD
• Pure Chiropractic Family LLC
• Pure Chiropractic PC
• Pure Healthcare of Arizona LLC
• Pure Healthcare of Arizona LLC

• Family Medicine Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.