J Edson Pontes, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4301031303 Issued in MI

Practice address

4100 John R St
Detroit, MI 48201-2013

Phone

(800) 527-6266

Fax

(313) 966-8207

NPI assigned

May 28, 2006

Sex

Male

Sole proprietor

No

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Northwest Michigan Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Traverse City, MI
  • NPI 1144645250

  Corporate Director

  CMS ownership
• Northwest Michigan Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Shelby, MI
  • NPI 1306262258

  Corporate Director

  CMS ownership
• Northwest Michigan Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Manistee, MI
  • NPI 1326589961

  Corporate Officer

  CMS ownership
• Northwest Michigan Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Benzonia, MI
  • NPI 1922464254

  Corporate Director

  CMS ownership

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.

• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment
• Harper Hutzel Hospital

  • Clinic/Center
  • Detroit, MI
  • NPI 1417150327
  NPD (past)
• University Physician Group

  • Counselor
  • Detroit, MI
  • NPI 1447465661
  NPD (past)
• University Urology

  • Urology Physician
  • Detroit, MI
  • NPI 1710910351
  NPD (past)

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1285681981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK BLVD",
            "address_2": "STE 2 WEST CREDENTIALING DEPT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-448-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "800-527-6266",
            "fax_number": "313-966-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTES",
        "first_name": "J",
        "middle_name": "EDSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301031303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandro Emmanuel Ponce Sepulveda
• Adrienne Ponce
• Melissa Ponce, LLMSW
• Cassandra Ponder, LMSW
• Kaylah Ponder, BA, CADC-DP
• Prathvi Poojary, D.D.S.
• Diana Pool, MA,MS, RSST, CHW
• Akeista Marie Poole
• Kelsey Poole, BSN, RDN, BFPC, CHW
• Pavi Elle Shanell Poole

• Urology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.