Active NPI
David Ming Pon, M.D., M.P.H.
- Ophthalmology Physician
- Leesburg, FL
National Provider Identifier
1336248723
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jan 18, 2018.
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME58295
- Practice address
- 601 E Dixie Ave
Suite 1003
Leesburg, FL 34748-5953 - Phone
- (352) 787-4588
- Fax
- (352) 323-9022
- NPI assigned
- Sep 21, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | ME58295 | FL | Primary |
Addresses
Primary practice location
601 E Dixie Ave
Suite 1003
Leesburg, FL 34748-5953
Mailing address
601 E Dixie Ave
Suite 1003
Leesburg, FL 34748-5953
Phone (352) 787-4588
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051690200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336248723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 E DIXIE AVE",
"address_2": "SUITE 1003",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347485953",
"telephone_number": "352-787-4588",
"fax_number": "352-323-9022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 E DIXIE AVE",
"address_2": "SUITE 1003",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347485953",
"telephone_number": "352-787-4588",
"fax_number": "352-323-9022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PON",
"first_name": "DAVID",
"middle_name": "MING",
"credential": "M.D., M.P.H.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME58295",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051690200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Leesburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.