Active NPI
Patricia Ponto, PH.D.
- Clinical Psychologist
- Kalamazoo, MI
National Provider Identifier
1427226653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301006201
- Practice address
- 2503 Glenwood Dr
Kalamazoo, MI 49008-2490 - Phone
- (269) 303-3888
- NPI assigned
- Feb 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301006201 | MI | Primary |
Addresses
Primary practice location
2503 Glenwood Dr
Kalamazoo, MI 49008-2490
Mailing address
2503 Glenwood Dr
Kalamazoo, MI 49008-2490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240109003229 | MI | Practitioner - Psychologist Billing Independently | 9234562034 | Practice locations: Kalamazoo, MI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674432000000",
"number": "1427226653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2503 GLENWOOD DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490082490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2503 GLENWOOD DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490082490",
"telephone_number": "269-303-3888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONTO",
"first_name": "PATRICIA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-11",
"last_updated": "2023-01-23",
"certification_date": "2023-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301006201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.