Individual provider Active NPI

Ariel Ponce, D.O.

  • Family Medicine Physician
  • Burton, MI
National Provider Identifier
1164458592
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101016332 Issued in MI
Practice address
4075 S Center Rd
Burton, MI 48519-1453
Phone
(810) 743-4120
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101016332 MI Primary

Addresses

Primary practice location

4075 S Center Rd
Burton, MI 48519-1453

Mailing address

4075 S Center Rd
Burton, MI 48519-1453
Phone (810) 743-4120

Other identifiers 1

IdentifierTypeStateIssuer
4769600MedicaidMI

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
I20081103000709 MI Practitioner - Family Practice 2264591494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians

Practice addresses (Care Compare)

4075 S Ctr Rd
Burton, MI 48519-1453
Phone (810) 743-4120

Hospital & facility affiliations

  • Compassus Home Health Home health agency, Grand Blanc, MI, CCN 237073
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016332MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Medical Group Genesys CurrentSince Aug 21, 2018 Accepting new patients
Genesys Pho LLC CurrentSince Apr 3, 2018 Accepting new patients
Henry Ford Medical Group Genesys Family Medicine CurrentSince Aug 21, 2018 Accepting new patients
Henry Ford Medical Group Genesys Family Medicine Current Accepting new patients

Locations

4075 S Center Rd
Burton, MI 48519
Phone (810) 743-4120

2184 S Ballenger Hwy
Flint, MI 48503
Phone (810) 232-5627

307 E Court St
Flint, MI 48502
Phone (810) 341-7370

3495 S Center Rd
Flint, MI 48519
Phone (810) 424-2025

10785 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 695-6337

Interoperability endpoints

  • Direct secure messaging: arielponce@pmi.allscriptsdirect.net
  • Direct secure messaging: aponce1144838@direct.hfhs.org

Organizations & group practices 4

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 4

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1164458592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191453",
            "telephone_number": "810-743-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191453",
            "telephone_number": "810-743-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE",
        "first_name": "ARIEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101016332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4769600",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

Verify at the official NPI Registry.