Ponnambalam S Sundram, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036070565 Issued in IL

Practice address

71 W 156TH St
Ste 305
Harvey, IL 60426-4260

Phone

(708) 331-2200

Fax

(708) 331-8015

NPI assigned

Jan 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: psundrammd237130@uchospital.direct-ci.com

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.

• Advanced Heart Group SC

  • Cardiovascular Disease Physician
  • Harvey, IL
  • NPI 1518945989
  Medicare reassignment NPD
• Olympia Fields Internal Medicine

  • Family Medicine Physician
  • Flossmoor, IL
  • NPI 1336170844
  NPD (past)

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298246400000",
    "number": "1437137478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 W 156TH ST",
            "address_2": "STE 305",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604264260",
            "telephone_number": "708-331-2200",
            "fax_number": "708-331-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 W 156TH ST",
            "address_2": "STE 305",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604264260",
            "telephone_number": "708-331-2200",
            "fax_number": "708-331-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDRAM",
        "first_name": "PONNAMBALAM",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2011-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036070565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360705655",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "060058942",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Star Med Lab, Inc
• Janet Vokoun Starck, M.D.
• Nicole Stephen, PHARMD
• Anita A. Stewart, M.D.
• Mark Stossel, M.D.
• Sara C Sungkapan, MS, OTR/L
• Jane Elizabeth Sutkowski, CNM
• Erica E Taylor, MD
• Jennifer Taylor, MD
• The Ingalls Memorial Hospital

• Cardiovascular Disease Physician in Harvey, IL
• Providers in Harvey, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; 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.

Verify at the official NPI Registry.