Individual provider Active NPI

Jyothi Punnam, M.D.

  • Internal Medicine Physician
  • Sacaton, AZ
National Provider Identifier
1407066988
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40129 Issued in AZ
Practice address
483 W Seed Farm Rd
Sacaton, AZ 85147-5000
Phone
(602) 528-1200
Fax
(602) 528-1255
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 40129 AZ
Internal Medicine Physician 207R00000X 40129 AZ Primary

Addresses

Primary practice location

483 W Seed Farm Rd
Sacaton, AZ 85147-5000

Mailing address

PO Box 115
Sacaton, AZ 85147-0002
Phone (520) 796-2600

Other identifiers 1

IdentifierTypeStateIssuer
371082MedicaidAZ

Other names 1

  • Jyothi Enugala Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 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
I20080930000467 AZ Practitioner - Internal Medicine 1355418518 Reassigns benefits to 2 organizations
I20240130001756 TX Practitioner - Internal Medicine 1355418518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Hospitalists, PLLCGroup PAC ID 0941290290, 50 clinicians

Practice addresses (Care Compare)

475 S Dobson Rd
Chandler, AZ 85224-5605
Phone (888) 488-7640

483 W Seed Farm Rd
Hu Hu Kam Memorial Hospital
Sacaton, AZ 85147-0038
Phone (602) 528-7100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
76.88
Promoting interoperability
76
Improvement activities
40
Cost
73.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Hospitalists, PLLC Internal Medicine CurrentSince Jun 28, 2010 Accepting new patients
Gila River Health Care Corporation CurrentSince Nov 27, 2023 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Comprehensive Hospitalist Services of Arizona, LLC Hospitalist CurrentSince Dec 1, 2009 Accepting new patients
Comprehensive Hospitalist Services of Arizona LLC Hospitalist CurrentSince Dec 1, 2009 Accepting new patients
Gila River Health Care CurrentSince Nov 27, 2023 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients

Locations

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

3100 W Ray Rd
Ste 201
Chandler, AZ 85226
Phone (269) 312-1446

3115 S Price Rd
Chandler, AZ 85248
Phone (480) 855-4011

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

Organizations & group practices 7

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1407066988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470002",
            "telephone_number": "520-796-2600",
            "fax_number": "602-528-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 W SEED FARM RD",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851475000",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNNAM",
        "first_name": "JYOTHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "40129",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "40129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371082",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JYOTHI",
            "last_name": "ENUGALA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sacaton, AZ

Sources for this page

Verify at the official NPI Registry.