Individual provider Active NPI

Hari B Ponnuru, M.D.

  • Anesthesiology Physician
  • Beaumont, TX
National Provider Identifier
1801930102
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G7306 Issued in TX
Practice address
755 N 11TH St
Suite P3600
Beaumont, TX 77702-1501
Phone
(409) 838-5214
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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 G7306 TX Primary

Addresses

Primary practice location

755 N 11TH St
Suite P3600
Beaumont, TX 77702-1501

Mailing address

PO Box 5587
Beaumont, TX 77726-5587
Phone (409) 838-5214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100619000165 TX Practitioner - Anesthesiology 7416026349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates Group PLLCGroup PAC ID 2264792449, 35 clinicians

Practice addresses (Care Compare)

3440 Fannin St
Beaumont, TX 77701-3803
Phone (469) 437-3564

Hospital & facility affiliations

  • Baptist Beaumont Hospital Hospital, Beaumont, TX, CCN 450346

National Provider Directory

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

Organizations & group practices 1

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 1

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1801930102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5587",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777265587",
            "telephone_number": "409-838-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P3600",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021501",
            "telephone_number": "409-838-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONNURU",
        "first_name": "HARI",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "G7306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.