Susan Jane Ponivas, RN, ANP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5015271 Issued in NC

Practice address

602 Ivy St FL 2
Elmira, NY 14905-1646

Phone

(607) 737-4333

Fax

(607) 737-4271

NPI assigned

Jul 1, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

State University of New York at Buffalo School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mount St. Marys Hospital of Niagara FallsGroup PAC ID 4082523790, 89 clinicians

Mercy Hospital of BuffaloGroup PAC ID 8729991666, 198 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
• Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Mercy Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1164464921
  Medicare reassignment Care Compare group NPD
• Mount St. Mary'S Hospital of Niagara Falls

  • General Acute Care Hospital
  • Lewiston, NY
  • NPI 1043394745
  Medicare reassignment Care Compare group NPD
• Trinity Medical Wny PC

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1295043149
  Medicare reassignment NPD
• Mercy Hospital of Buffalo

  • Rehabilitation Hospital Unit
  • Buffalo, NY
  • NPI 1659310605
  NPD
• Trinity Medical Wny PC

  • Vascular Surgery Physician
  • Buffalo, NY
  • NPI 1205468055
  NPD

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

• Mercy Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1164464921
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Cheektowaga, NY
  • NPI 1043455199
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1790727543
  Care Compare affiliation

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1467614230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 N JUSTICE ST",
            "address_2": "STE A",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287913455",
            "telephone_number": "828-697-7377",
            "fax_number": "828-697-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 IVY ST FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051646",
            "telephone_number": "607-737-4333",
            "fax_number": "607-737-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONIVAS",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "RN, ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015271",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "304914",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04652273",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Platten, LMSW
• Alison Renee Platukis, CNM
• William F Pochal Jr., M.D., D.D.S.
• Kelly Polidori, LMSW
• Andrea R Poluka, LMSW
• Positively Psyched Counseling LCSW PLLC
• Kathleen Pottinger
• Kristie L Pound, LCSW
• Paul Peter Povanda, D.O.
• Morgan Povoski, OTR/L

• Nurse Practitioner in Elmira, NY
• Providers in Elmira, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.