Active NPI
David Joseph Ponte, MA PT OCS
- Physical Therapist
- Eureka, CA
National Provider Identifier
1649252230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT57811
- Practice address
- 2820 Harris St
Eureka, CA 95503-4809 - Phone
- (707) 268-8219
- Fax
- (707) 268-8264
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT57811 | CA | Primary |
Addresses
Primary practice location
2820 Harris St
Eureka, CA 95503-4809
Mailing address
2820 Harris St
Eureka, CA 95503-4809
Phone (707) 268-8219
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649252230 | Other | CA | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040302000625 | CA | Practitioner - Physical Therapist in Private Practice | 0345137675 | Practice locations: Eureka, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Stanford University School of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2820 Harris St
Eureka, CA 95503-4809
Phone (707) 268-8219
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT57811 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241395200000",
"number": "1649252230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2820 HARRIS ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955034809",
"telephone_number": "707-268-8219",
"fax_number": "707-268-8264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 HARRIS ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955034809",
"telephone_number": "707-268-8219",
"fax_number": "707-268-8264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONTE",
"first_name": "DAVID",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "MA PT OCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2009-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT57811",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1649252230",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.