Jerry Frederick Ponce, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT35664 Issued in CA

Practice address

2010 Wilshire Blvd
Suite 404
Los Angeles, CA 90057-3507

Phone

(213) 353-0003

Fax

(213) 353-0004

NPI assigned

Aug 25, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Soft Physical Therapy

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1437464096
  NPD (past)

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1609009612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 WILSHIRE BLVD",
            "address_2": "SUITE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573507",
            "telephone_number": "213-353-0003",
            "fax_number": "213-353-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 WILSHIRE BLVD",
            "address_2": "SUITE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573507",
            "telephone_number": "213-353-0003",
            "fax_number": "213-353-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE",
        "first_name": "JERRY",
        "middle_name": "FREDERICK",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT35664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Ponce, BA, CADC III
• Carmen L Ponce
• Diana Maribel Ponce, PA
• Edson Geovany Ponce
• Gloria Ponce
• Jessica Ponce
• Maria C. Ponce, M.D.
• Mayra Ponce
• Mayra Ponce, APCC
• Noemy Ponce, LCSW, PPSC

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.