Individual provider Active NPI

Madhukar K. Punja, M.D.

  • Allergy & Immunology Physician
  • Gainesville, FL
National Provider Identifier
1508892118
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
ME #55179 Issued in FL
Practice address
1173 NW 64TH Ter
Gainesville, FL 32605-4218
Phone
(352) 331-2485
Fax
(352) 331-0047
NPI assigned
Jun 24, 2006
Last updated
Feb 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X ME #55179 FL Primary

Addresses

Primary practice location

1173 NW 64TH Ter
Gainesville, FL 32605-4218

Mailing address

1173 NW 64TH Ter
Gainesville, FL 32605-4218
Phone (352) 331-2485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100804000765 FL Practitioner - Allergy/Immunology 0042343527 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME #55179FLMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Specialty Care PA CurrentSince May 1, 2010 Accepting new patients
Allergy Sinus & Asthma Specialty Care Past Accepting new patients

Locations

213 SW Main Blvd
Lake City, FL 32025
Phone (386) 961-9809

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1508892118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-331-2485",
            "fax_number": "352-331-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-331-2485",
            "fax_number": "352-331-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNJA",
        "first_name": "MADHUKAR",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME #55179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.