Active NPI
Roberta (M) Ponemon, PA
- Physician Assistant
- Albany, NY
National Provider Identifier
1649497082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001586
- Practice address
- 47 New Scotland Ave
Albany,, NY 12208 - Phone
- (518) 262-4317
- Fax
- (518) 262-2671
- NPI assigned
- Apr 19, 2007
- Last updated
- May 27, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001586 | NY | Primary |
Addresses
Primary practice location
47 New Scotland Ave
Albany,, NY 12208
Mailing address
143 Orchard St
Delmar, NY 12054
Phone (518) 439-0517
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital Region Midwifery, PLLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Midwife
- Troy, NY
- NPI 1629355250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1649497082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 ORCHARD ST",
"city": "DELMAR",
"state": "NY",
"postal_code": "12054",
"telephone_number": "518-439-0517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 NEW SCOTLAND AVE",
"city": "ALBANY,",
"state": "NY",
"postal_code": "12208",
"telephone_number": "518-262-4317",
"fax_number": "518-262-2671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONEMON",
"first_name": "ROBERTA",
"middle_name": "(M)",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "001586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.