Active NPI
Amy M Pond, PA
- Physician Assistant
- Fort Wayne, IN
National Provider Identifier
1710387121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10001828A
- Practice address
- 11141 Parkview Plaza Dr Ste 305
Fort Wayne, IN 46845 - Phone
- (260) 266-8900
- Fax
- (260) 266-8935
- NPI assigned
- Sep 4, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA11421 | TX | |
| Physician Assistant | 363A00000X | 004085 | OH | |
| Physician Assistant | 363A00000X | 10001828A | IN | Primary |
Addresses
Primary practice location
11141 Parkview Plaza Dr Ste 305
Fort Wayne, IN 46845
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other practice location 1
17520 W Grand Pkwy S Ste 450
Sugar Land, TX 77479-4758
Phone (281) 633-7800
Other practice location 2
23920 Katy Fwy Ste 240
Katy, TX 77494-0881
Phone (281) 664-8881
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 153449704 | Other | TX | MEDICAID GRP PRACTICE TPI # |
| 00106W | Other | TX | MEDICARE GRP PTAN # |
| 0035TD | Other | TX | BCBSTX GRP PRACTICE RECORD # |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | apond194179@Direct.Parkviewexchange.com | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/ | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 83.53 of 100
- Quality
- 70
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.11
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004085 | OH | MD | Peer Specialist |
Interoperability endpoints
- apond194179@direct.parkviewexchange.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1710387121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11141 PARKVIEW PLAZA DR STE 305",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "46845",
"telephone_number": "260-266-8900",
"fax_number": "260-266-8935"
}
],
"practiceLocations": [
{
"address_1": "17520 W Grand Pkwy S Ste 450",
"address_purpose": "LOCATION",
"city": "Sugar Land",
"state": "TX",
"postal_code": "774794758",
"country_code": "US",
"telephone_number": "281-633-7800",
"fax_number": "281-633-7815",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "23920 Katy Fwy Ste 240",
"address_purpose": "LOCATION",
"city": "Katy",
"state": "TX",
"postal_code": "774940881",
"country_code": "US",
"telephone_number": "281-664-8881",
"fax_number": "281-644-8879",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POND",
"first_name": "AMY",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-04",
"last_updated": "2022-11-30",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA11421",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "004085",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10001828A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GRP PRACTICE TPI #",
"identifier": "153449704",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GRP PTAN #",
"identifier": "00106W",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSTX GRP PRACTICE RECORD #",
"identifier": "0035TD",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "apond194179@Direct.Parkviewexchange.com",
"affiliation": "N",
"address_1": "11141 Parkview Plaza Dr Ste 305",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "46845",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "11141 Parkview Plaza Dr Ste 305",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "46845",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
"affiliation": "N",
"address_1": "11141 Parkview Plaza Dr Ste 305",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "46845",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.