Abhilasha Rao Ponnamaneni, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA08964100 Issued in NJ

Practice address

639 Stokes Rd
Suite 102
Medford, NJ 08055-3003

Phone

(609) 654-7556

Fax

(609) 714-9228

NPI assigned

Aug 4, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Internal MedicineAlso: Cardiovascular Disease (Cardiology)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of New Jersey Omb Centralized PayrollGroup PAC ID 6406742592, 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: medrecs@deborah.medalliesdirect.net

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.

• State of New Jersey Omb Centralized Payroll

  • Psychiatric Hospital
  • Hammonton, NJ
  • NPI 1629155502
  Medicare reassignment Care Compare group NPD
• Professional Service Fund of Deborah Heart & Lung Center

  • Specialist
  • Browns Mills, NJ
  • NPI 1407803596
  Medicare reassignment NPD
• Deborah Heart and Lung Center

  • General Acute Care Hospital
  • Browns Mills, NJ
  • NPI 1467440743
  NPD
• Professional Service Fund of Deborah- Anesthesia

  • Specialist
  • Browns Mills, NJ
  • NPI 1902852015
  NPD
• State of New Jersey Omb Centralized Payroll

  dba Greystone Park Psychiatric Hospital

  • Psychiatric Hospital
  • Morris Plains, NJ
  • NPI 1336221878
  NPD
• Dorfner Family Medicine LLC

  • Internal Medicine Physician
  • Burlington, NJ
  • NPI 1164432407
  NPD (past)
• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1548574346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 SUNSET RD",
            "address_2": "SUITE 101",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080163645",
            "telephone_number": "609-387-9242",
            "fax_number": "609-387-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 STOKES RD",
            "address_2": "SUITE 102",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080553003",
            "telephone_number": "609-654-7556",
            "fax_number": "609-714-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONNAMANENI",
        "first_name": "ABHILASHA",
        "middle_name": "RAO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08964100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Pinto, D.O.
• Kelsey Pio
• Zachary Piotrowski, DPT
• Mistella Pistone, BCBA
• Ashley Podheiser, MS, CCC-SLP
• Positive Pathways Behavior Services
• Robin P. Potestio, PA-C
• Precision Eye Physcians and Surgeons
• Premier Eye Medford LLC (Premier Eye Associates)
• Premier Spine and Wellness Inc

• Family Medicine Physician in Medford, NJ
• Providers in Medford, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.