Active NPI
Puja Haridasan Nambiar, M.D.
- Infectious Disease Physician
- Shreveport, LA
National Provider Identifier
1871881979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 305319
- Practice address
- 1501 Kings Hwy
Shreveport, LA 71103-4228 - Phone
- (318) 626-0386
- Fax
- (318) 698-8005
- NPI assigned
- Jul 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125.059096 | IL | |
| Infectious Disease Physician | 207RI0200X | 305319 | LA | Primary |
Addresses
Primary practice location
1501 Kings Hwy
Shreveport, LA 71103-4228
Mailing address
1501 Kings Highway
Attn: Leisa Oglesby (RM. 1-201)
Shreveport, LA 71103-4228
Phone (318) 675-4881
Other practice location 1
836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 296-5944
Other practice location 2
836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 296-5944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Infectious Disease
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000
Hospital & facility affiliations
- Memorial Hospital for Cancer and Allied Diseases
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305896 | NY | MD | Licensed Practical Nurse |
| 125.059096 | IL | MD | Internal Medicine Physician |
| 305319 | LA | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Infectious Disease Group | Infectious Disease | Current | Accepting new patients |
Locations
633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764
1275 York Ave
New York, NY 10065
Phone (212) 639-3813
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Interoperability endpoints
- pnambiar26796@mskcc.direct-ci.com
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.
-
- Infectious Disease Physician
- New York, NY
- NPI 1619948189
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Basking Ridge, NJ
- NPI 1659385474
-
- General Acute Care Hospital
- New York, NY
- NPI 1700887411
-
- General Acute Care Hospital
- Montvale, NJ
- NPI 1841650330
-
- General Acute Care Hospital
- Middletown, NJ
- NPI 1528428521
-
- Special Hospital
- New York, NY
- NPI 1770046351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1871881979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 KINGS HIGHWAY",
"address_2": "ATTN: LEISA OGLESBY (RM. 1-201)",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711034228",
"telephone_number": "318-675-4881",
"fax_number": "318-675-5069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 KINGS HWY",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711034228",
"telephone_number": "318-626-0386",
"fax_number": "318-698-8005"
}
],
"practiceLocations": [
{
"address_1": "836 W Wellington Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606575147",
"country_code": "US",
"telephone_number": "773-296-5944",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "836 W Wellington Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606575147",
"country_code": "US",
"telephone_number": "773-296-5944",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NAMBIAR",
"first_name": "PUJA",
"middle_name": "HARIDASAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-11",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125.059096",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "LA",
"license": "305319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.