Active NPI
Aida B. Ponce, M.D.
- Pediatric Adolescent Medicine Physician
- Saginaw, MI
National Provider Identifier
1598714396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- ABP040553
- Practice address
- 144 N Frost Dr
Suite 4
Saginaw, MI 48638-7186 - Phone
- (989) 790-7665
- Fax
- (989) 790-9147
- NPI assigned
- May 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | ABP040553 | MI | Primary |
Addresses
Primary practice location
144 N Frost Dr
Suite 4
Saginaw, MI 48638-7186
Mailing address
144 N Frost Dr
Suite 4
Saginaw, MI 48638-7186
Phone (989) 790-7665
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3507333702 | Other | MI | BLUE CROSS ID# |
| P60002 | Other | MI | BLUE CARE NETWORK ID# |
| 0400553 | Other | MI | HEALTH PLUS ID # |
| 1587050 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160517002232 | MI | Order and Referring Only - Pediatric Medicine | 2264721018 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ABP040553 | MI | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1598714396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 N FROST DR",
"address_2": "SUITE 4",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486387186",
"telephone_number": "989-790-7665",
"fax_number": "989-790-9147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "144 N FROST DR",
"address_2": "SUITE 4",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486387186",
"telephone_number": "989-790-7665",
"fax_number": "989-790-9147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONCE",
"first_name": "AIDA",
"middle_name": "B.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-09",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "MI",
"license": "ABP040553",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS ID#",
"identifier": "3507333702",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK ID#",
"identifier": "P60002",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS ID #",
"identifier": "0400553",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1587050",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saginaw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.