Individual provider Active NPI

Ludovic Ponivadh Pao, MD

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1619506649
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
U9049 Issued in TX
Practice address
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone
(972) 715-5000
NPI assigned
Apr 2, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X U9049 TX Primary

Addresses

Primary practice location

12222 Merit Dr Ste 600
Dallas, TX 75251-3294

Mailing address

12222 Merit Dr Ste 600
Dallas, TX 75251-3294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240827004600 TX Practitioner - Anesthesiology 6204375827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-6356

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
  • Baylor Scott and White Medical Center Uptown Hospital, Dallas, TX, CCN 450422
  • Medical City Plano Hospital, Plano, TX, CCN 450651
  • Baylor Scott & White Medical Center - Frisco Hospital, Frisco, TX, CCN 450853

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U9049TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U. S. Anesthesia Partners of Texas, P.a., Single Specialty CurrentSince Aug 2, 2024 Accepting new patients
U S Anesthesia Partners of Texas, PA Anesthesiology CurrentSince Aug 2, 2024 Accepting new patients

Locations

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

3500 Gaston Ave
Dallas, TX 75246

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1619506649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513294",
            "telephone_number": "972-715-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAO",
        "first_name": "LUDOVIC",
        "middle_name": "PONIVADH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "U9049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.