Ellie Marie Pontiakos, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12577 Issued in GA

Practice address

4700 Waters Ave
Savannah, GA 31404-6220

Phone

(912) 350-8000

NPI assigned

Jul 29, 2024

Last updated

Oct 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036
• Coastal Carolina Hospital Hospital, Hardeeville, SC, CCN 420101
• Novant Health Hilton Head Medical Center Hospital, Hilton Head Island, SC, CCN 420080

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  GA

  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Savannah Health Services, LLC

  dba Memorial Health University Medical Center

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1053824292
  Care Compare affiliation
• Hilton Head Medical Center LLC

  dba Novant Health Hilton Head Medical Center

  • General Acute Care Hospital
  • Hilton Head Island, SC
  • NPI 1902675101
  Care Compare affiliation
• South Carolina Coastal Medical Center LLC

  dba Novant Health Coastal Carolina Hospital

  • General Acute Care Hospital
  • Hardeeville, SC
  • NPI 1205605409
  Care Compare affiliation

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1609605724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 RIVER BLUFF RD",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298416056",
            "telephone_number": "704-577-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTIAKOS",
        "first_name": "ELLIE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12577",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Earl Pollock, RBT
• Luis Polo, NP
• Ryan Stephen Polsinelli, PA-C
• Tara Ann Polson, PSY.D.
• Haley Pon
• Ashley Poole
• Imani Poole, LCSW
• Michael D Poole, M.D.
• Sarah Elizabeth Poole, PHARMD
• Jannie Pope

• Physician Assistant in Savannah, GA
• Providers in Savannah, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.
• 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.