Individual provider Active NPI

Sasidharan Ponthenkandath, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Riverside, CA
National Provider Identifier
1215132790
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
28183 Issued in WI
Practice address
3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone
(844) 827-8000
NPI assigned
Jun 15, 2007
Last updated
Mar 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 28183 WI Primary

Addresses

Primary practice location

3390 University Ave Ste 100
Riverside, CA 92501-3315

Mailing address

3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone (844) 827-8000

Other identifiers 3

IdentifierTypeStateIssuer
137-405-7OtherECFMG
30783600MedicaidWI
559798OtherWIUHC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171121003252 CA Practitioner - Pediatric Medicine 9537426853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as group
Quality
82.43
Promoting interoperability
100
Improvement activities
40
Cost
65.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28183WIMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Sep 20, 2017 Accepting new patients
Ucr Health - Psychiatry CurrentSince Sep 20, 2017 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

39000 Bob Hope Dr
Ste 310
Rancho Mirage, CA 92270

3390 University Ave
Ste 1
Riverside, CA 92501
Phone (951) 827-7793

3390 University Ave
Ste 100
Riverside, CA 92501
Phone (844) 827-8000

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

3865 Jackson St
Riverside, CA 92503
Phone (909) 688-2211

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1215132790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTHENKANDATH",
        "first_name": "SASIDHARAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WI",
            "license": "28183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG",
            "identifier": "137-405-7",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30783600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "559798",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.