Edson Gerry Ponraj, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00043988 Issued in WA

Practice address

11315 Bridgeport Way SW
Lakewood, WA 98499-3004

Phone

(253) 589-8700

Fax

(253) 581-6588

NPI assigned

Jun 4, 2006

Last updated

Mar 5, 2008By the provider in NPPES

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 5

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Emergency Medicine

Education

Loma Linda University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Clare Hospital Hospital, Lakewood, WA, CCN 500021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eponraj9900@fhsce.catholichealth.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Emergency Physicians LLC

  dba Nep

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370
  Medicare reassignment Care Compare group NPD
• Northwest Physician Associates, Apc

  • Emergency Medicine Physician
  • Federal Way, WA
  • NPI 1407127442
  NPD (past)
• Tacoma Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1134321888
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Clare Hospital

  dba Paclab

  • Clinical Medical Laboratory
  • Lakewood, WA
  • NPI 1003029745

  Hospital

  Care Compare affiliation
• Saint Clare Hospital

  dba ST. Clare Hospital

  • General Acute Care Hospital
  • Lakewood, WA
  • NPI 1689672693
  Care Compare affiliation

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1396783940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11315 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993004",
            "telephone_number": "253-589-8700",
            "fax_number": "253-581-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONRAJ",
        "first_name": "EDSON",
        "middle_name": "GERRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00043988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "2165PO",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8400749",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0186778",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "1186PO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0186779",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PNW Mobile Clinic
• Nikhila Pokkuluri
• Jenna Poland
• Pietro M Poletti, MD
• Alison N Polwarth, DDS
• Melody Pope, LMP
• Caitlyn Popovich
• Ashely Nicole Porter, NCPS
• Semeria Portillo
• Linda Sue Posey, BA

• Emergency Medicine Physician in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.