Michael A. Pond, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

270563-1206 Issued in UT

Practice address

Fairfax Rd at Virginia St
Salt Lake City, UT 84103-4399

Phone

(801) 536-3600

Fax

(801) 536-3686

NPI assigned

Nov 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Shriners Hospitals for Children

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD (past)

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1104005503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FAIRFAX RD AT VIRGINIA ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841034399",
            "telephone_number": "801-536-3600",
            "fax_number": "801-536-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FAIRFAX RD AT VIRGINIA ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841034399",
            "telephone_number": "801-536-3600",
            "fax_number": "801-536-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POND",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "270563-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madyson Lynn Pomeroy
• Claire Pomorski, RD
• Janiece Lynn Pompa, PH.D.
• Sean Anthony Ponce, M.D.
• Britany Shealyn Pond
• Sierra Grace Pond, MS GC
• Steven Howard Pond III, DDS
• Rebecca Louise Ponder, M.D.
• Thitirat Pongprajuc
• David Eric Pontious, M.P.A.S., P.A.C

• Surgical Physician Assistant in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Surgical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.