Individual provider Active NPI

Nandakumar Ponnusamy, MD

  • Pain Medicine (Anesthesiology) Physician
  • Springfield, MA
National Provider Identifier
1225268204
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
257197 Issued in MA
Practice address
Bay State Medical Ctr
759 Chestnut Street
Springfield, MA 01199-0001
Phone
(413) 794-4326
NPI assigned
Jul 23, 2009
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 257197 MA
Pain Medicine (Anesthesiology) Physician 207LP2900X 257197 MA Primary

Addresses

Primary practice location

Bay State Medical Ctr
759 Chestnut Street
Springfield, MA 01199-0001

Mailing address

1350 Main St Ste 1300
Springfield, MA 01103-6107
Phone (413) 794-4326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20140113000882 MA Practitioner - AnesthesiologyPractitioner - Pain Management 3173767498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

3400 Main St
Springfield, MA 01107-1113
Phone (413) 794-9560

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Anesthesia Service, Inc. Anesthesiology CurrentSince Dec 17, 2013 Accepting new patients
Baystate Medical Practices, Inc CurrentSince Jan 1, 2025 Accepting new patients
Hampden County Physician Associates, LLC. PastSince Jan 1, 2025 Accepting new patients

Locations

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

3400 Main St
Springfield, MA 01107
Phone (413) 794-8777

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

908 Allen St
Springfield, MA 01118
Phone (413) 732-5139

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.

Hospital & facility affiliations 4

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": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1225268204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 MAIN ST STE 1300",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011036107",
            "telephone_number": "413-794-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BAY STATE MEDICAL CTR",
            "address_2": "759 CHESTNUT STREET",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011990001",
            "telephone_number": "413-794-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONNUSAMY",
        "first_name": "NANDAKUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-23",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "257197",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MA",
            "license": "257197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.