Individual provider Active NPI

Vikram Ettigounder Ponnusamy, MD

  • Ophthalmology Physician
  • Orlando, FL
National Provider Identifier
1093335937
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME177994 Issued in FL
Practice address
95 Columbia St
Orlando, FL 32806-1101
Phone
(407) 849-9621
Fax
(407) 420-4056
NPI assigned
Apr 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X ME177994 FL
Ophthalmology Physician 207W00000X ME177994 FL Primary

Addresses

Primary practice location

95 Columbia St
Orlando, FL 32806-1101

Mailing address

95 Columbia St
Orlando, FL 32806-1101
Phone (407) 849-9621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240710001726 NJ Practitioner - Ophthalmology 0648601070 Reassigns benefits to 1 organization
I20260518003556 FL Practitioner - Ophthalmology 0648601070

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Missouri, Columbia School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Retinal Consultants LLCGroup PAC ID 2961509161, 115 clinicians

Practice addresses (Care Compare)

10 Plum St
Suite 600
New Brunswick, NJ 08901-2065
Phone (732) 220-1600

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038
  • Monmouth Medical Center-Southern Campus Hospital, Lakewood, NJ, CCN 310084

Merit-based Incentive Payment System (MIPS)

Final score
91.52 of 100Reported as group
Quality
95.9
Promoting interoperability
100
Improvement activities
40
Cost
75.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12225600NJMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Retinal Consultants LLC CurrentSince Jul 1, 2024 Accepting new patients
Associated Retinal Consultants LLC Ophthalmology CurrentSince Jul 1, 2024 Accepting new patients

Locations

10 Plum St
Ste 600
New Brunswick, NJ 08901
Phone (732) 220-1600

420 Mountain Ave
Fl 4
New Providnce, NJ 07974

2 Capital Way
Ste 326
Pennington, NJ 08534
Phone (609) 882-8833

628 Cedar Ln
Teaneck, NJ 07666
Phone (201) 837-7300

Interoperability endpoints

  • Direct secure messaging: vponnusamy@arcnj.intellechartdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1093335937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061101",
            "telephone_number": "407-849-9621",
            "fax_number": "904-996-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061101",
            "telephone_number": "407-849-9621",
            "fax_number": "407-420-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONNUSAMY",
        "first_name": "VIKRAM",
        "middle_name": "ETTIGOUNDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-21",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME177994",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME177994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.