Individual provider Active NPI

Sarah Ponder, PAC

  • Medical Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1639294564
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
200107 Issued in LA
Practice address
7777 Hennessy Blvd Ste 5000
Baton Rouge, LA 70808-4368
Phone
(225) 765-7163
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 200107 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd Ste 5000
Baton Rouge, LA 70808-4368

Mailing address

18509 Red Oak Dr
Prairieville, LA 70769-3742
Phone (225) 677-7124

Other practice location 1

5439 Airline Hwy
Baton Rouge, LA 70805-1712
Phone (225) 358-4853

Other practice location 2

1401 N Foster Dr
Baton Rouge, LA 70806-1818
Phone (225) 987-9084

Other practice location 3

7777 Hennessy Blvd Ste 102
Baton Rouge, LA 70808-4363
Phone (225) 765-2048

Other identifiers 1

IdentifierTypeStateIssuer
1035068MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sponder15324@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080204000672 LA Practitioner - Physician Assistant 2062594690 Reassigns benefits to 2 organizations
I20100304000635 LA Practitioner - Physician Assistant 2062594690 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Emergency Physician Associates, LLCGroup PAC ID 1759317092, 78 clinicians
Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-8826

7777 Hennessy Blvd
Baton Rouge, LA 70808-4363

Hospital & facility affiliations

  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
200107LAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Nov 1, 2019 Accepting new patients
Our Lady of the Lake Physician Group LLC Physician Assistant CurrentSince Nov 1, 2019 Accepting new patients

Locations

5439 Airline Hwy
Baton Rouge, LA 70805
Phone (225) 358-2280

5000 Hennessy Blvd
Ste B
Baton Rouge, LA 70808

1401 N Foster Dr
Baton Rouge, LA 70806
Phone (225) 987-9000

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

1125 W Highway 30
Gonzales, LA 70737
Phone (225) 621-2975

5000 Odonavan Blvd
Walker, LA 70785
Phone (225) 214-4200

Interoperability endpoints

  • Direct secure messaging: sponder15324@direct.casso.us.com

Organizations & group practices 4

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 1

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1639294564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18509 RED OAK DR",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693742",
            "telephone_number": "225-677-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 5000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084368",
            "telephone_number": "225-765-7163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5439 Airline Hwy",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708051712",
            "country_code": "US",
            "telephone_number": "225-358-4853",
            "fax_number": "225-358-2350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 N Foster Dr",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708061818",
            "country_code": "US",
            "telephone_number": "225-987-9084",
            "fax_number": "225-987-9096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7777 Hennessy Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084363",
            "country_code": "US",
            "telephone_number": "225-765-2048",
            "fax_number": "225-765-1957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONDER",
        "first_name": "SARAH",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "200107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035068",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sponder15324@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sponder15324@direct.casso.us.com",
            "address_1": "7777 Hennessy Blvd Ste 102",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7777 Hennessy Blvd Ste 102",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.