Kathleen Ryan Ponsford, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA60090604 Issued in WA

Practice address

305 SE Chkalov Dr Ste 170
Vancouver, WA 98683

Phone

(360) 787-7135

Fax

(360) 799-3913

NPI assigned

Jun 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.62 of 100Reported as apm

Quality

77.21

Promoting interoperability

99.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  WA

  Medicare reassignment Care Compare group NPD
• Legacy Salmon Creek Hospital

  dba Legacy Salmon Creek Providers

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784
  Medicare reassignment Care Compare group
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD (past)
• Legacy Mount Hood Medical Center

  • General Acute Care Hospital
  • Gresham, OR
  • NPI 1255354700
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1053548669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SE CHKALOV DR STE 170",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98683",
            "telephone_number": "360-787-7135",
            "fax_number": "360-799-3913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005 W Main St",
            "address_purpose": "LOCATION",
            "city": "Battle Ground",
            "state": "WA",
            "postal_code": "986044311",
            "country_code": "US",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONSFORD",
        "first_name": "KATHLEEN",
        "middle_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60090604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0252790",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Martin Pollock
• Judith A Pollock, RN
• Alla Polyakov
• Feliks Polyakov
• Sarah Pongon, PT
• McKinzi M Pontious, OTR/L
• Katherine A Poole, CRNA
• Lokesh Popli, M.D.
• Landon Eugene Poppleton, PHD, JD
• Heather Lavelle Porch, BSW

• Medical Physician Assistant in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.

Verify at the official NPI Registry.