Active NPI
Gary C Ponto, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Goleta, CA
National Provider Identifier
1508893355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- G37701
- Practice address
- 5652 Calle Real
Goleta, CA 93117-2317 - Phone
- (805) 967-1539
- Fax
- (805) 964-8489
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | G37701 | CA | Primary |
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | G37701 | CA |
Addresses
Primary practice location
5652 Calle Real
Goleta, CA 93117-2317
Mailing address
5652 Calle Real
Goleta, CA 93117-2317
Phone (805) 967-1539
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0058760 | Medicaid | CA | |
| 00G377010 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37701 | CA | MD | Marriage & Family Therapist |
| G37701 | CA | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Coast Pathology Consultants, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Medical Laboratory
- San Luis Obispo, CA
- NPI 1558320143
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394150400000",
"number": "1508893355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5652 CALLE REAL",
"city": "GOLETA",
"state": "CA",
"postal_code": "931172317",
"telephone_number": "805-967-1539",
"fax_number": "805-964-8489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5652 CALLE REAL",
"city": "GOLETA",
"state": "CA",
"postal_code": "931172317",
"telephone_number": "805-967-1539",
"fax_number": "805-964-8489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONTO",
"first_name": "GARY",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2014-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CA",
"license": "G37701",
"primary": true
},
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "CA",
"license": "G37701",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0058760",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G377010",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goleta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.