Individual provider Active NPI

Stephanie E Pongracz, PA

  • Surgical Physician Assistant
  • Santa Monica, CA
National Provider Identifier
1508172016
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA20968 Issued in CA
Practice address
2020 Santa Monica Blvd
Suite 400
Santa Monica, CA 90404-2023
Phone
(310) 928-2663
Fax
(310) 315-2198
NPI assigned
Aug 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA20968 CA Primary

Addresses

Primary practice location

2020 Santa Monica Blvd
Suite 400
Santa Monica, CA 90404-2023

Mailing address

1658 Camden Ave
No 105
Los Angeles, CA 90025-7548
Phone (805) 403-3755

Other names 1

  • Stephanie E Wright Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101222000950 CA Practitioner - Physician Assistant 3678761210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

2020 Santa Monica Blvd
Santa Monica, CA 90404-2139
Phone (310) 829-2663

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone (310) 576-7267

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone (310) 823-8911

8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674

Hospital & facility affiliations

  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20968CAMDOccupational Therapist
PA20968CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 21, 2014 Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

2020 Santa Monica Blvd
Ste 400
Santa Monica, CA 90404
Phone (310) 315-2068

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Interoperability endpoints

  • Direct secure messaging: spongracz197266@direct.cshs.org

Organizations & group practices 2

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 1

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1508172016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 CAMDEN AVE",
            "address_2": "NO 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257548",
            "telephone_number": "805-403-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 SANTA MONICA BLVD",
            "address_2": "SUITE 400",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042023",
            "telephone_number": "310-928-2663",
            "fax_number": "310-315-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONGRACZ",
        "first_name": "STEPHANIE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA20968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "WRIGHT",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.