Sean Anthony Ponce, M.D.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

4976571-1205 Issued in UT

Practice address

3802 S 700 E
Salt Lake City, UT 84106-1182

Phone

(801) 264-6004

Fax

(801) 264-6098

NPI assigned

Jul 10, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Atm Counseling & Medical Services

  • Specialist
  • Sandy, UT
  • NPI 1174787196
  NPD (past) Authorized official
• Jordan Family Health, LLC

  • Family Medicine Physician
  • West Jordan, UT
  • NPI 1164672770
  NPD (past)
• Mountainstar Medical Group-St. Marks Hospital, LLC

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1073795258
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1376577049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061182",
            "telephone_number": "801-264-6004",
            "fax_number": "801-264-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061182",
            "telephone_number": "801-264-6004",
            "fax_number": "801-264-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE",
        "first_name": "SEAN",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "UT",
            "license": "4976571-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376577049",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisia Kay Polzin
• Taylor K. Pomeranz, MD
• Madyson Lynn Pomeroy
• Claire Pomorski, RD
• Janiece Lynn Pompa, PH.D.
• Britany Shealyn Pond
• Michael A. Pond, PAC
• Sierra Grace Pond, MS GC
• Steven Howard Pond III, DDS
• Rebecca Louise Ponder, M.D.

• Addiction Medicine (Family Medicine) Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Addiction Medicine (Family Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.