Individual provider Active NPI

Pamela Ann Onderko, D.P.M.

  • Podiatrist
  • Macon, GA
National Provider Identifier
1366413775
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000778 Issued in GA
Practice address
5223 Riverside Dr Ste 104
Macon, GA 31210-0889
Phone
(478) 200-7143
Fax
(478) 254-9704
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000778 GA Primary

Addresses

Primary practice location

5223 Riverside Dr Ste 104
Macon, GA 31210-0889

Mailing address

5223 Riverside Dr Ste 104
Macon, GA 31210-0889
Phone (478) 200-7143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080401000422 GA Practitioner - Podiatry 7517044506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5223 Riverside Dr
Suite 104
Macon, GA 31210-0889
Phone (478) 200-7143

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Macon, GA, CCN 117152
  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue226
Removal of skin lesions21
Removal of nail tissue1274
Removal or shaving of skin growth426
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
778GAMDClinical Psychologist
000778GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Sports Medicine & Orthopaedic Clinic, PC CurrentSince Sep 5, 2023 Accepting new patients

Locations

4660 Riverside Park Blvd
Macon, GA 31210
Phone (478) 471-6300

1625 Hardeman Ave
Macon, GA 31201
Phone (478) 474-2114

Organizations & group practices 2

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 2

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1366413775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5223 RIVERSIDE DR STE 104",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312100889",
            "telephone_number": "478-200-7143",
            "fax_number": "478-254-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5223 RIVERSIDE DR STE 104",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312100889",
            "telephone_number": "478-200-7143",
            "fax_number": "478-254-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONDERKO",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "000778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.