Individual provider Active NPI

Robin K Pond, M.M.S., PA-C

  • Physician Assistant
  • Crystal Lake, IL
National Provider Identifier
1124449558
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.004939 Issued in IL
Practice address
5911 Northwest Highway
Suite 205
Crystal Lake, IL 60014
Phone
(847) 515-2200
Fax
(847) 515-2328
NPI assigned
Jan 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.004939 IL Primary

Addresses

Primary practice location

5911 Northwest Highway
Suite 205
Crystal Lake, IL 60014

Mailing address

5911 Northwest Highway
Suite 205
Crystal Lake, IL 60014
Phone (847) 515-2200

Other names 1

  • Robin K Danielson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231009003298 AZ Practitioner - Physician Assistant 4587888276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Midwestern University College of Dental Medicine, Downers Grove, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arizona Pain Specialists PLLCGroup PAC ID 2668536418, 40 clinicians

Practice addresses (Care Compare)

2905 W Warner Rd
Suite 19
Chandler, AZ 85224-1674
Phone (480) 563-6400

9787 N 91St St
Suite 101
Scottsdale, AZ 85258-5088
Phone (480) 563-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.004939ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Pain Specialists, PLLC CurrentSince Sep 18, 2023 Accepting new patients
Arizona Pain Specialists, PLLC CurrentSince Sep 18, 2023 Accepting new patients
Adventist Health Partners,Inc Past Accepting new patients
Physical Medicine of Chandler LLC PastSince May 1, 2020 Accepting new patients
Adventist Health Partners, Inc Past Accepting new patients

Locations

2905 W Warner Rd
Chandler, AZ 85224
Phone (480) 603-9000

2905 W Warner Rd
Ste 19
Chandler, AZ 85224
Phone (480) 899-2101

18555 N 79th Ave
Ste D101
Glendale, AZ 85308
Phone (480) 245-6169

13460 N 94th Dr
Peoria, AZ 85381
Phone (623) 223-1036

2340 W Parkside Ln
Ste H107
Phoenix, AZ 85027
Phone (480) 245-6008

9787 N 91st St
Ste 101
Scottsdale, AZ 85258
Phone (480) 845-0334

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1124449558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 NORTHWEST HIGHWAY",
            "address_2": "SUITE 205",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "847-515-2200",
            "fax_number": "847-515-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 NORTHWEST HIGHWAY",
            "address_2": "SUITE 205",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "847-515-2200",
            "fax_number": "847-515-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POND",
        "first_name": "ROBIN",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "M.M.S., PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.004939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "DANIELSON",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.