Individual provider Active NPI

Breanna M Pond, M.D.

  • Obstetrics Physician
  • Marquette, MI
National Provider Identifier
1134214547
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
4301079739 Issued in MI
Practice address
1414 W Fair Avenue
Suite 390
Marquette, MI 49855
Phone
(906) 225-3881
Fax
(906) 225-0994
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301079739 MI
Gynecology Physician 207VG0400X 4301079739 MI
Obstetrics Physician 207VX0000X 4301079739 MI Primary

Addresses

Primary practice location

1414 W Fair Avenue
Suite 390
Marquette, MI 49855

Mailing address

1414 W Fair Avenue
Suite 390
Marquette, MI 49855
Phone (906) 225-3881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051006000685 MI Practitioner - Obstetrics/Gynecology 5597780783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Michigan State University College of Human Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB-GYN Assoc of Marquette PCGroup PAC ID 4789650243, 7 clinicians

Practice addresses (Care Compare)

1414 W Fair Ave
Marquette, MI 49855-5407
Phone (906) 225-3881

Hospital & facility affiliations

  • Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301079739MIMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN Assoc of Marquette PC Obstetrics & Gynecology CurrentSince Sep 18, 2006 Accepting new patients
DLP Marquette General Hospital LLC Past Accepting new patients

Locations

843 W Washington St
Ste 1
Marquette, MI 49855

1414 W Fair Ave
Ste 390
Marquette, MI 49855
Phone (906) 225-3881

Interoperability endpoints

  • Direct secure messaging: breanna.pond.1@20714.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1134214547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVENUE",
            "address_2": "SUITE 390",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-3881",
            "fax_number": "906-225-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVENUE",
            "address_2": "SUITE 390",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-3881",
            "fax_number": "906-225-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POND",
        "first_name": "BREANNA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301079739",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "4301079739",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "MI",
            "license": "4301079739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.