Individual provider Active NPI

Poorna Subramaniam

  • Anesthesiology Physician
  • Memphis, TN
National Provider Identifier
1306959366
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
40558 Issued in TN
Practice address
50 N Dunlap St
Memphis, TN 38103-2800
Phone
(901) 287-6060
NPI assigned
Aug 16, 2006
Last updated
Jul 26, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 40558 TN Primary

Addresses

Primary practice location

50 N Dunlap St
Memphis, TN 38103-2800

Mailing address

8010 Stage Hills Blvd
Bartlett, TN 38133-4032
Phone (901) 291-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20070102000368 TN Practitioner - Anesthesiology 8628078391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Lebonheur Pediatric Specialists, Inc.Group PAC ID 7719173939, 162 clinicians

Practice addresses (Care Compare)

100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 287-7337

848 Adams Ave
Memphis, TN 38103-2816

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40558TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Anesthesiologists P a Anesthesiology CurrentSince Oct 1, 2006 Accepting new patients
Pediatric Anesthesiologists PA Past Accepting new patients

Locations

50 N Dunlap St
Memphis, TN 38103
Phone (901) 522-3060

Interoperability endpoints

  • Direct secure messaging: psubramaniam31844@mlh.direct-ci.com

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1306959366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 STAGE HILLS BLVD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334032",
            "telephone_number": "901-291-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032800",
            "telephone_number": "901-287-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBRAMANIAM",
        "first_name": "POORNA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "40558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.