| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SHIVA PAVAN PONAMGI | 1669743118 | 2024-07-07 |
Shiva Pavan Ponamgi is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1669743118. Registration indicates Shiva Pavan Ponamgi is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Internal Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Internal Medicine) (Internal Medicine, ) (Allopathic & Osteopathic Physicians, Internal Medicine) (Primary Care/Family Planning/APRN/PA, ) (Internal Medicine, Allopathic & Osteopathic Physicians) Access to Cardiologists (Allopathic & Osteopathic Physicians, Internal Medicine) (Cardiovascular Disease (Internal Medicine),, ) (Allopathic & Osteopathic Physicians, Internal Medicine) (Internal Medicine: Cardiovascular Disease, ) (Specialist Network, ) (Internal Medicine Cardiovascular Disease, Allopathic & Osteopathic Physicians) (Internal Medicine, ) (Allopathic & Osteopathic Physicians, Hospitalist) (Hospitalist, ) (All Other Specialties & Provider Types, ) (Hospitalist, Allopathic & Osteopathic Physicians) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Shiva Pavan Ponamgi M.D. |
| Practice Office Address | 7500 MERCY RD OMAHA, NE US |
| Practice Office Telephone | 4023985880 |
| Mailing Address | 7500 MERCY RD OMAHA, NE 681242319 US |
| Business Telephone | 4023985880 |
| Direct Messaging Address [] | [email protected] |
| Code | Practice | License No State |
|---|---|---|
| 207R00000X | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Internal MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Internal Medicine Internal Medicine Allopathic & Osteopathic Physicians Internal Medicine Primary Care/Family Planning/APRN/PA Internal Medicine Allopathic & Osteopathic Physicians | 57047
MN |
| 207RC0000X PRIMARY | Access to Cardiologists Allopathic & Osteopathic Physicians Internal Medicine Cardiovascular Disease (Internal Medicine), Allopathic & Osteopathic Physicians Internal Medicine Internal Medicine: Cardiovascular Disease Specialist Network Internal Medicine Cardiovascular Disease Allopathic & Osteopathic Physicians Internal Medicine | 36422
NE |
| 208M00000X | Allopathic & Osteopathic Physicians Hospitalist Hospitalist All Other Specialties & Provider Types Hospitalist Allopathic & Osteopathic Physicians | 57047
MN |
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | PERMIT ONLY
NJ |