Adriana Elizabeth Pons, PA-C, NP-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9471096 Issued in ID

Practice address

190 E Bannock St FL 9
Boise, ID 83712-6241

Phone

(208) 381-3971

Fax

(208) 381-2566

NPI assigned

Jul 25, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, ID2 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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment NPD
• Anjani Thakur, MD, Inc

  • Surgery Physician
  • Turlock, CA
  • NPI 1508877473
  Medicare reassignment
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1417297821
  NPD
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)
• Vijaya Thakur MD Inc

  • Internal Medicine Physician
  • Turlock, CA
  • NPI 1144274366
  NPD (past)

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1073891016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST FL 9",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-3971",
            "fax_number": "208-381-2566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953504404",
            "country_code": "US",
            "telephone_number": "209-577-3388 x2275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONS",
        "first_name": "ADRIANA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "9471096",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21665",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "21713",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Charles Ponce, PHARMD
• Daniel Kenneth Pond, PA-C
• Katie Marie Pond, LCSW
• Matthew Pond, M.D.
• Supriya Ponnapula, PHARM.D.
• Steven Edward Pontickio, M.D.
• Leslie Glenn Pool, M.D.
• Michael W Pool, M.D.
• Olana Rae Pool, CSFA, CSA, CST
• Colin E Poole, MD

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.