Individual provider Active NPI

Sonali Ponkshe, MD

  • Psychiatry Physician
  • Augusta, GA
National Provider Identifier
1619606084
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
13825 Issued in GA
Practice address
1459 Laney Walker Blvd
Augusta, GA 30912-0002
Phone
(706) 721-2273
NPI assigned
Jun 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 13825 GA Primary

Addresses

Primary practice location

1459 Laney Walker Blvd
Augusta, GA 30912-0002

Mailing address

3538 Gleneagles Dr
Martinez, GA 30907-9507

Other identifiers 1

IdentifierTypeStateIssuer
4044056502OtherGAPHONE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL citrix.augusta.edu

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260626002975 GA Practitioner - Psychiatry 8921489568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1211 W 22ND St
Suite 406
Oak Brook, IL 60523-2169

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1619606084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3538 GLENEAGLES DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 LANEY WALKER BLVD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120002",
            "telephone_number": "706-721-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONKSHE",
        "first_name": "SONALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "13825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHONE NUMBER",
            "identifier": "4044056502",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "citrix.augusta.edu",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "1459 Laney Walker Blvd",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309120002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.