Gabriela Ponce, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT18929 Issued in FL

Practice address

4500 W Shannon Lakes Dr Ste 3
Tallahassee, FL 32309-2240

Phone

(850) 942-2000

Fax

(850) 942-2003

NPI assigned

Apr 2, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Lansdowne, VA
  • NPI 1861552721
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1568968337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 W SHANNON LAKES DR STE 3",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092240",
            "telephone_number": "850-942-2000",
            "fax_number": "850-942-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 W SHANNON LAKES DR STE 3",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092240",
            "telephone_number": "850-942-2000",
            "fax_number": "850-942-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE",
        "first_name": "GABRIELA",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT18929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4500 W Shannon Lakes Dr Ste 3",
            "city": "Tallahassee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "323092240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dwight Luke Polivka, ARNP
• Amy Nicole Pollock I
• Alice Karen Pomidor, M.D.
• Jacquella J Pompey
• Wyshanta Pompey, MS; MSW
• Harley Laing Ponder, MD
• Vamsi Ponnaganti, M.D.
• Pontchartrain Lithotripsy, LLC
• Anyah Poole
• Lana Skipper Poole, CRNA

• Occupational Therapist in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.