Martin Ngu Kwale Pong, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

280285 Issued in AZ

Practice address

4338 W Thomas Rd
Phoenix, AZ 85031-3878

Phone

(682) 307-0864

NPI assigned

Mar 31, 2023

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Health Group Providers LLCGroup PAC ID 9335430693, 24 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.24 of 100Reported as group

Quality

71.1

Promoting interoperability

68

Improvement activities

40

Cost

69.7

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: martin.pong.1@24259.direct.athenahealth.com

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.

• Health Group Providers, LLC

  • Psychiatry Physician
  • Tempe, AZ
  • NPI 1932560729
  Medicare reassignment Care Compare group NPD
• Connectionsaz, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1083840953
  Medicare reassignment
• Behavioral Health Solutions of Arizona PLLC

  • Psychiatry Physician
  • Tempe, AZ
  • NPI 1265357495
  NPD (past)

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1245935204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4338 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850313878",
            "telephone_number": "682-307-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4338 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850313878",
            "telephone_number": "682-307-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONG",
        "first_name": "MARTIN",
        "middle_name": "NGU KWALE",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "280285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shiyu Ponciano, MD
• Casey Pond
• Diane Lea Pond, M.D.
• Ponderosa Psychiatry PLLC
• Mirela Ponduchi, MD
• Valerie Pong, DNP
• Pongratz Orthotics & Prosthetics, Inc.
• Pongratz Orthotics and Prosthetics, Inc.
• Trevor M. Ponte, D.O.
• Aristidis Pontikas, DMD MS

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.