Individual provider Active NPI

Timothy Ponder, MD

  • Diagnostic Radiology Physician
  • Desoto, TX
National Provider Identifier
1396794004
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G4493 Issued in TX
Practice address
1750 North Hampton Road
Desoto, TX 75115
Phone
(214) 946-4397
Fax
(214) 946-4399
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G4493 TX Primary

Addresses

Primary practice location

1750 North Hampton Road
Desoto, TX 75115

Mailing address

1750 North Hampton Road
Desoto, TX 75115
Phone (214) 946-4397

Other identifiers 1

IdentifierTypeStateIssuer
102401001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040128000620 TX Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 7618870718 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 1977
Medicare assignment
May accept Medicare assignment
Group practices
Radiology Associates of North Texas PAGroup PAC ID 7911897301, 340 clinicians
Methodist-CdiGroup PAC ID 3072836600, 43 clinicians

Practice addresses (Care Compare)

17980 Dallas Pkwy
Suite 200
Dallas, TX 75287-6817
Phone (817) 321-0937

7300 Eldorado Pkwy
Suite 170
McKinney, TX 75070-7895
Phone (972) 920-0150

Hospital & facility affiliations

  • Methodist Charlton Medical Center Hospital, Dallas, TX, CCN 450723
  • Methodist Dallas Medical Center Hospital, Dallas, TX, CCN 450051

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G4493TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist-Cdi Diagnostic Radiology CurrentSince Aug 7, 2015 Accepting new patients
Methodist-Cdi Diagnostic Radiology CurrentSince Aug 7, 2015 Accepting new patients
Methodist-Cdi Diagnostic Radiology Current Accepting new patients
Radiology Associates of North Texas PA Diagnostic Radiology CurrentSince Mar 1, 2016 Accepting new patients
Rca Advanced Imaging LP Diagnostic Radiology Past Accepting new patients

Locations

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

1750 N Hampton Rd
Desoto, TX 75115
Phone (214) 420-5400

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

2975 E Broad St
Ste 101
Mansfield, TX 76063
Phone (214) 420-5445

7300 Eldorado Pkwy
Ste 170
McKinney, TX 75070
Phone (972) 920-0150

8080 Independence Pkwy
Ste 105
Plano, TX 75025
Phone (972) 208-1858

5425 W Spring Creek Pkwy
Ste 110
Plano, TX 75024
Phone (214) 718-0100

Interoperability endpoints

  • Direct secure messaging: tponder1430626@direct.sw.org

Organizations & group practices 6

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1396794004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 NORTH HAMPTON ROAD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "75115",
            "telephone_number": "214-946-4397",
            "fax_number": "214-946-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 NORTH HAMPTON ROAD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "75115",
            "telephone_number": "214-946-4397",
            "fax_number": "214-946-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDER",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "G4493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102401001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.