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SOUMYA MANNOOR PUNNOOSE PMHNP
NPI 1063376911
Nurse Practitioner - Psychiatric/Mental Health in Frederick, MD

Active since December 15, 2025PECOS Enrolled
196 THOMAS JOHNSON DR STE 230, FREDERICK, MD 21702(833) 444-4267 Get Directions Write a Review

NPPES record last updated: December 15, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Soumya Mannoor Punnoose Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUMYA MANNOOR PUNNOOSE PMHNP (NPI 1063376911) is an individual psychiatric/mental health provider in Frederick, Maryland, licensed in Maryland (R221507) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1063376911
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameSOUMYA MANNOOR PUNNOOSECredential: PMHNP
Location Address196 THOMAS JOHNSON DR STE 230Frederick, MD 21702-4524
Mailing Address196 Thomas Johnson Dr Ste 230Frederick, MD 21702-4524 · (833) 444-4267
Phone(833) 444-4267
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateDecember 15, 2025
NPPES CertifiedDecember 15, 2025
✔ NPI 1063376911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MD · R221507
196 THOMAS JOHNSON DR STE 230, Frederick, MD 21702
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Soumya Mannoor Punnoose Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2961967716
PECOS Enrollment IDI20260722001345
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Soumya Mannoor Punnoose reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

My Med Clinic PA
19 mi
Geriatric Medicine
19731 EXECUTIVE PARK CIR
Germantown, MD 20874
  • Reassigned Medicare billing, District of Columbia enrollment
  • 3 clinicians in this Medicare group
NPI 1245403849 (301) 698-3245

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21702 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.75 typical visit price
range $57.99 – $175.57
Typical copayment $22.43 (range $14.49 – $43.89)
Most-billed visit code 99203
Established Patient
$102.11 typical visit price
range $18.66 – $143.02
Typical copayment $25.52 (range $4.66 – $35.75)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Soumya Mannoor Punnoose's NPI number?

The NPI number for Soumya Mannoor Punnoose is 1063376911. It was assigned to this individual provider in the NPPES registry on December 15, 2025.

Where is Soumya Mannoor Punnoose located?

Soumya Mannoor Punnoose practices at 196 Thomas Johnson Dr Ste 230, Frederick, MD 21702. The listed phone number is (833) 444-4267.

What is Soumya Mannoor Punnoose's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Soumya Mannoor Punnoose enrolled in Medicare?

Yes. Soumya Mannoor Punnoose is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Soumya Mannoor Punnoose's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Soumya Mannoor Punnoose reassigns Medicare benefits to My Med Clinic PA (Germantown, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Soumya Mannoor Punnoose's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Soumya Mannoor Punnoose was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.