Individual provider Active NPI

Pamela Polensky-Bonser, AUD

  • Audiologist
  • Spokane, WA
National Provider Identifier
1689841371
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
LD00002295 Issued in WA
Practice address
217 W Cataldo Ave FL 2
Spokane, WA 99201-2217
Phone
(509) 624-2326
Fax
(509) 744-3040
NPI assigned
May 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X LD00002295 WA Primary

Addresses

Primary practice location

217 W Cataldo Ave FL 2
Spokane, WA 99201-2217

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other identifiers 3

IdentifierTypeStateIssuer
0308042OtherWALABOR & INDUSTRIES
2031137MedicaidWA
P00647352OtherWARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081104000405 WA Practitioner - Qualified Audiologist 7719046895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

217 W Cataldo Ave
Spokane, WA 99201-2217
Phone (509) 624-2326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD00002295WAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Surgical Specialists, PS CurrentSince Oct 1, 2008 Accepting new patients
Columbia Surgical Specialists, PS CurrentSince Oct 1, 2008 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 8, 2022 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

217 W Cataldo Ave
Spokane, WA 99201
Phone (509) 624-2326

217 W Cataldo Ave
Fl 2
Spokane, WA 99201
Phone (509) 624-2326

9922 N Nevada St
Spokane, WA 99218
Phone (509) 624-2326

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.

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1689841371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W CATALDO AVE FL 2",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012217",
            "telephone_number": "509-624-2326",
            "fax_number": "509-744-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLENSKY-BONSER",
        "first_name": "PAMELA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD00002295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0308042",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2031137",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00647352",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.

Verify at the official NPI Registry.