Individual provider Active NPI

Natalya Igorevna Ponomareva, MD

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
National Provider Identifier
1205696952
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
125.083909 Issued in IL
Practice address
420 E Superior St Ste 9-900
Chicago, IL 60611-4494
Phone
(312) 503-7975
NPI assigned
Mar 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 125.083909 IL Primary

Addresses

Primary practice location

420 E Superior St Ste 9-900
Chicago, IL 60611-4494

Mailing address

420 E Superior St Ste 9-900
Chicago, IL 60611-4494
Phone (312) 503-7975

Other names 1

  • Natasha Ponomareva Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240706000215 IL Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 2567906191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.083909ILMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1205696952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E SUPERIOR ST STE 9-900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114494",
            "telephone_number": "312-503-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E SUPERIOR ST STE 9-900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114494",
            "telephone_number": "312-503-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONOMAREVA",
        "first_name": "NATALYA",
        "middle_name": "IGOREVNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "125.083909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATASHA",
            "last_name": "PONOMAREVA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.