Individual provider Active NPI

Paula Pons, M.D.

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Fayetteville, NY
National Provider Identifier
1679533483
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
License
227287 Issued in NY
Practice address
5413 Springview Drive
Fayetteville, NY 13066
Phone
(315) 637-2003
Fax
(315) 329-7772
NPI assigned
Mar 24, 2006
Last updated
Dec 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 227287 NY Primary

Addresses

Primary practice location

5413 Springview Drive
Fayetteville, NY 13066

Mailing address

5413 Springview Drive
Fayetteville, NY 13066
Phone (315) 637-2003

Other identifiers 1

IdentifierTypeStateIssuer
02364547MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060707000234 NY Practitioner - General SurgeryPractitioner - Emergency Medicine 7517979925 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227287NYMDUndersea and Hyperbaric Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pons Physician Services, PLLC CurrentSince Mar 29, 2016 Accepting new patients
St Josephs Hospital Health Center CurrentSince Dec 1, 2020 Accepting new patients
St Joseph's Hospital Health Center CurrentSince Dec 1, 2020 Accepting new patients

Locations

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

1 Guthrie Dr
Corning, NY 14830
Phone (607) 937-7130

4005 West Rd
#281
Cortland, NY 13045
Phone (607) 753-0993

4206 Medical Center Dr
Ste 206
Fayetteville, NY 13066
Phone (315) 329-2600

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

Interoperability endpoints

  • Direct secure messaging: ppons@direct-address.org
  • Direct secure messaging: ppons2388754@direct.trinity-health.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1679533483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5413 SPRINGVIEW DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "315-637-2003",
            "fax_number": "315-329-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5413 SPRINGVIEW DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "315-637-2003",
            "fax_number": "315-329-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONS",
        "first_name": "PAULA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "NY",
            "license": "227287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02364547",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

Verify at the official NPI Registry.