Active NPI
Ponnamma Medappa Chenanda, M.D.
- Anesthesiology Physician
- Lancaster, CA
National Provider Identifier
1962426494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A84213
- Practice address
- 1600 W Avenue J
Lancaster, CA 93534-2814 - Phone
- (661) 949-5000
- Fax
- (661) 949-5971
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- 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 | A84213 | CA | Primary |
Addresses
Primary practice location
1600 W Avenue J
Lancaster, CA 93534-2814
Mailing address
PO Box 60790
Pasadena, CA 91116-6790
Phone (626) 795-6596
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A842130 | Other | CA | BLUE SHIELD |
| 00A842130 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- 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
- Anesthesiology
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1600 W Ave J
Lancaster, CA 93534-2814
Phone (661) 949-5000
Hospital & facility affiliations
- Antelope Valley Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A84213 | CA | MD | Anesthesiology Physician |
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.
-
- Anesthesiology Physician
- Lancaster, CA
- NPI 1639104144
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lancaster, CA
- NPI 1366419517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391126400000",
"number": "1962426494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60790",
"city": "PASADENA",
"state": "CA",
"postal_code": "911166790",
"telephone_number": "626-795-6596",
"fax_number": "626-795-8247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 W AVENUE J",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935342814",
"telephone_number": "661-949-5000",
"fax_number": "661-949-5971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENANDA",
"first_name": "PONNAMMA",
"middle_name": "MEDAPPA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2014-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A84213",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00A842130",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A842130",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; 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.