Individual provider Active NPI

Trevor M. Ponte, D.O.

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1538367065
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
008457 Issued in AZ
Practice address
645 E Missouri Ave Ste 300
Phoenix, AZ 85012-1351
Phone
(602) 262-8900
Fax
(602) 262-8890
NPI assigned
Jul 5, 2007
Last updated
Jan 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036129529 IL
Anesthesiology Physician 207L00000X DO-04470 IA
Anesthesiology Physician 207L00000X 008457 AZ Primary

Addresses

Primary practice location

645 E Missouri Ave Ste 300
Phoenix, AZ 85012-1351

Mailing address

4200 University Ave
Suite 300
West Des Moines, IA 50266-5945
Phone (515) 401-1950

Other practice location 1

4200 University Ave Ste 300
West Des Moines, IA 50266-5945
Phone (154) 011-9585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210120002223 AZ Practitioner - Anesthesiology 2163672379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Anesthesiology Consultants IncGroup PAC ID 4880591841, 284 clinicians
Anesthesia Partners of Arizona LLCGroup PAC ID 8628317179, 85 clinicians

Practice addresses (Care Compare)

1500 S Dobson Rd
Suite 101
Mesa, AZ 85202-4722
Phone (480) 412-3577

3535 N Scottsdale Rd
Scottsdale, AZ 85251-5625
Phone (480) 882-4365

4605 E Elwood St
Suite 500
Phoenix, AZ 85040-1978
Phone (602) 200-9021

9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone (480) 323-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
008457AZMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Anesthesiology Consultants, Inc. Anesthesiology CurrentSince Dec 1, 2020 Accepting new patients
University Anesthesiologists SC Anesthesiology Past Accepting new patients

Locations

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012
Phone (602) 262-8917

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1538367065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 UNIVERSITY AVE",
            "address_2": "SUITE 300",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665945",
            "telephone_number": "515-401-1950",
            "fax_number": "515-401-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8900",
            "fax_number": "602-262-8890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 University Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "502665945",
            "country_code": "US",
            "telephone_number": "154-011-9585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONTE",
        "first_name": "TREVOR",
        "middle_name": "M.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036129529",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "DO-04470",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "008457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.