Active NPI
Ponnudurai Nathan, MD
- Anesthesiology Physician
- Cinnaminson, NJ
National Provider Identifier
1821234972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 25MA03696700
- Practice address
- 106 Your Host LN
Cinnaminson, NJ 08077-4364 - Phone
- (856) 303-0898
- NPI assigned
- Dec 19, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 25MA03696700 | NJ | Primary |
Addresses
Primary practice location
106 Your Host LN
Cinnaminson, NJ 08077-4364
Mailing address
106 Your Host LN
Cinnaminson, NJ 08077-4364
Phone (856) 303-0898
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3944409 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03696700 | NJ | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229644800000",
"number": "1821234972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 YOUR HOST LN",
"city": "CINNAMINSON",
"state": "NJ",
"postal_code": "080774364",
"telephone_number": "856-303-0898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 YOUR HOST LN",
"city": "CINNAMINSON",
"state": "NJ",
"postal_code": "080774364",
"telephone_number": "856-303-0898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NATHAN",
"first_name": "PONNUDURAI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-19",
"last_updated": "2008-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NJ",
"license": "25MA03696700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3944409",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cinnaminson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.