NPIMap

Individual provider Active NPI

Chandra Kumar Ponniah, MBBS

  • Family Medicine Physician
  • Norfolk, NE
National Provider Identifier
1881858405
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26319 Issued in NE
Practice address
2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701-4449
Phone
(402) 844-8205
Fax
(402) 844-8206
NPI assigned
Jul 13, 2008
Last updated
Feb 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26319 NE Primary

Addresses

Primary practice location

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701-4449

Mailing address

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701-4449
Phone (402) 844-8205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110816000521 NE Practitioner - Family Practice 2062681612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Regional Physician Services LLCGroup PAC ID 5193786168, 194 clinicians

Practice addresses (Care Compare)

301 N 27TH St
Norfolk, NE 68701-4401

47452 268 Ave
Suite C
Humphrey, NE 68642-5178
Phone (402) 923-0150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.77 of 100Reported as group
Quality
67.03
Promoting interoperability
96
Improvement activities
40
Cost
72.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26319NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Nebraska Dept of Admin Services CurrentSince Aug 21, 2012 Accepting new patients
State of Nebraska Dept of Admin Services Current Accepting new patients
State of Nebraska Dept of Admin Services CurrentSince Aug 21, 2012 Accepting new patients
Ravenscroft Healthcare LLC Past Accepting new patients
Faith Regional Health Services Past Accepting new patients

Locations

600 E Benjamin Ave
Norfolk, NE 68701
Phone (402) 370-3330

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1215907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1881858405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 W NORFOLK AVE",
            "address_2": "STE 200",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014449",
            "telephone_number": "402-844-8205",
            "fax_number": "402-844-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 W NORFOLK AVE",
            "address_2": "STE 200",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014449",
            "telephone_number": "402-844-8205",
            "fax_number": "402-844-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONNIAH",
        "first_name": "CHANDRA",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-13",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "26319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.