Active NPI
Umakumaran P Ponniah, MD
- Pediatric Cardiology Physician
- Jacksonville, FL
National Provider Identifier
1093784746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- ME163207
- Practice address
- 841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350 - Phone
- (904) 202-8550
- Fax
- (904) 393-7808
- NPI assigned
- Mar 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | 24624 | OK | |
| Pediatric Cardiology Physician | 2080P0202X | ME163207 | FL | Primary |
Addresses
Primary practice location
841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350
Mailing address
PO Box 746645
Atlanta, GA 30374-6645
Phone (904) 376-4083
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1451 | NY | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Specialty Physicians Inc | Pediatric Cardiology | Current | Accepting new patients |
| Baptist Specialty Physicians Inc | Pediatric Cardiology | Current | Accepting new patients |
| Mercy Hospital Oklahoma City, Inc | Current | Accepting new patients | |
| Pediatric Cardiology Associates, LLC | Pediatric Cardiology | Past | Accepting new patients |
| The Nemours Foundation | Past | Accepting new patients |
Locations
841 Prudential Dr
Ste 280
Jacksonville, FL 32207
Phone (904) 202-8290
2418 E Plaza Dr
Tallahassee, FL 32308
Phone (850) 629-4861
4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962
Interoperability endpoints
- uponniah159885@direct.nemours.org
- uponniah26608@ouhealth.direct-ci.net
Organizations & group practices 6
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Jacksonville, FL
- NPI 1407226228
Pediatric Cardiology
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1386658615
-
- Pediatric Cardiology Physician
- Jacksonville, FL
- NPI 1184392847
-
- Physical Therapist
- Oklahoma City, OK
- NPI 1922192186
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
-
- Pediatric Cardiology Physician
- Syracuse, NY
- NPI 1932258985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1093784746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746645",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746645",
"telephone_number": "904-376-4083",
"fax_number": "904-391-5075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "841 PRUDENTIAL DR STE 280",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078350",
"telephone_number": "904-202-8550",
"fax_number": "904-393-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONNIAH",
"first_name": "UMAKUMARAN",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-15",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "OK",
"license": "24624",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "FL",
"license": "ME163207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.