NPIMap

Individual provider Active NPI

Harikrishna Choudary Ponnam, MD

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1073922316
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.128164 Issued in OH
Practice address
2475 E 22ND St Ste 120
Cleveland, OH 44115-3221
Phone
(216) 431-1500
NPI assigned
Aug 12, 2014
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.128164 OH Primary

Addresses

Primary practice location

2475 E 22ND St Ste 120
Cleveland, OH 44115-3221

Mailing address

PO Box 932127
Cleveland, OH 44193-0008
Phone (216) 431-1500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address directmedicalarts120@cleveland.ipsmso.com Outreach Professional Services Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160503001803 OH Practitioner - Internal Medicine 5193024776 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Ohio LLCGroup PAC ID 9032527221, 232 clinicians
Nurse Practitioner Health Services LLCGroup PAC ID 4880840115, 18 clinicians
Santibanez Pac Ohio IncGroup PAC ID 7416391545, 36 clinicians

Practice addresses (Care Compare)

141 N Forge St
Akron, OH 44304-1407
Phone (330) 375-3000

15400 Pearl Rd
Suite 238
Strongsville, OH 44136-6000
Phone (440) 879-1258

565 Bryn Mawr St
Ravenna, OH 44266-9696
Phone (330) 297-5781

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.128164OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Integrated Acute Care Services of Ohio, LLC Internal Medicine CurrentSince Dec 18, 2023 Accepting new patients
Nurse Practitioner Health Services, LLC CurrentSince Nov 25, 2024 Accepting new patients
Outreach Professional Services, Inc CurrentSince Jun 1, 2016 Accepting new patients
Outreach Professional Services Inc Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
Santibanez Pac Ohio Inc CurrentSince Jan 1, 2024 Accepting new patients
4M Hospitalist Services, LLC Internal Medicine CurrentSince Dec 6, 2022 Accepting new patients
Lutheran Hospital Past Accepting new patients
Tallmadge Healthcare Group, LLC Past Accepting new patients
Summa Health System Past Accepting new patients
Bath Manor Limited Partnership Past Accepting new patients
Bath Creek Healthcare Group, Inc. Past Accepting new patients
FHS Fairlawn, Inc. Past Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

141 N Forge St
Akron, OH 44304
Phone (330) 375-3361

29 N Adams St
Akron, OH 44304
Phone (330) 572-7293

2475 E 22nd St
Ste 120
Cleveland, OH 44115
Phone (216) 367-9444

3557 Embassy Pkwy
Fairlawn, OH 44333
Phone (330) 670-1005

19530 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-7500

565 Bryn Mawr St
Ravenna, OH 44266
Phone (330) 297-5781

275 E Sunset Dr
Rittman, OH 44270
Phone (330) 927-2060

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

15400 Pearl Rd
Ste 238
Strongsville, OH 44136
Phone (440) 879-1258

619 Northwest Ave
Tallmadge, OH 44278
Phone (234) 274-1888

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Timberland Ridge Nursing & RehabilitationFairlawn, OH, CCN 366479 Skilled nursing facility Adp of the SNF May 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1073922316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932127",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930008",
            "telephone_number": "216-431-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 E 22ND ST STE 120",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153221",
            "telephone_number": "216-431-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONNAM",
        "first_name": "HARIKRISHNA CHOUDARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-12",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.128164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "directmedicalarts120@cleveland.ipsmso.com",
            "affiliation": "Y",
            "affiliationName": "Outreach Professional Services Inc",
            "address_1": "2475 E 22nd St Ste 120",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441153221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.