Isabelle Ponge Wilson MD PC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

198244 Issued in NY

Legal business name

ISABELLE PONGE WILSON MD PC

Practice address

50 Park Ave
New York, NY 10016-3075

Phone

(212) 679-4134

Fax

(212) 679-7079

NPI assigned

Apr 2, 2007

Last updated

Jan 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Isabelle Ponge Wilson, MD

Title

Doctor

Phone

(212) 679-4134

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deirdre Marie Connolly, M.D.

  • Dermatology Physician
  • New York, NY
  • NPI 1881604700
  Medicare reassignment Care Compare group NPD
• Isabelle Ponge Wilson, M.D.

  • Specialist
  • New York, NY
  • NPI 1831278878
  Medicare reassignment Care Compare group NPD
• Richard W Green, MD

  • Dermatology Physician
  • Bronx, NY
  • NPI 1154301000
  NPD (past)
• Patricia Ofgang

  • Family Nurse Practitioner
  • Danbury, CT
  • NPI 1386773034
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1396866281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163075",
            "telephone_number": "212-679-4134",
            "fax_number": "212-679-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163075",
            "telephone_number": "212-679-4134",
            "fax_number": "212-679-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISABELLE PONGE WILSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "PONGE WILSON",
        "authorized_official_first_name": "ISABELLE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "212-679-4134",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "198244",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "198244",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "198244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Geriatric Center, Inc
• Isabella Geriatric Center, Inc.
• Isabella Geriatric Center, Inc.
• Isabella Nursing Home Inc
• Isabella Visiting Care Inc
• Oren K Isacoff, MD, MBA
• Alexandra Isaia, MD
• Verena Isak, MD
• Ethan Isakov
• Galina Isakov, MD

• Procedural Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Procedural Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.