Individual provider Active NPI

Chiara Elizabeth Ponko, AUD

  • Audiologist
  • Glen Burnie, MD
National Provider Identifier
1720767213
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
01666 Issued in MD
Practice address
802 Landmark Dr. Ste 119
Glen Burnie, MD 21061
Phone
(410) 760-8840
Fax
(410) 367-2464
NPI assigned
Jul 13, 2023
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 01666 MD Primary
Audiologist-Hearing Aid Fitter 237600000X 2201001921 VA
Audiologist-Hearing Aid Fitter 237600000X 01666 MD

Addresses

Primary practice location

802 Landmark Dr. Ste 119
Glen Burnie, MD 21061

Mailing address

802 Landmark Dr
Ste 119
Glen Burnie, MD 21061
Phone (410) 760-8840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240110004080 VA Practitioner - Qualified Audiologist 6901257229 Reassigns benefits to 1 organization
I20240412001262 MD Practitioner - Qualified Audiologist 6901257229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10285 Little Patuxent Pkwy
Suite 200
Columbia, MD 21044-3489
Phone (410) 760-8840

10710 Charter Dr
Suite 400
Columbia, MD 21044-3276
Phone (410) 997-7979

1300 York Rd
Suite 30D
Lutherville, MD 21093-6090
Phone (443) 275-1337

205 Ctr St
Suite 100
Mount Airy, MD 21771-5498
Phone (410) 760-8840

802 Landmark Dr
Suite 119
Glen Burnie, MD 21061-9121
Phone (410) 760-8840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01666MDMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Dec 16, 2023 Accepting new patients
Johns Hopkins Regional Physicians LLC CurrentSince Mar 20, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Dec 16, 2023 Accepting new patients
Johns Hopkins Regional Physicians LLC CurrentSince Mar 20, 2024 Accepting new patients

Locations

1630 Main St
Ste 217
Chester, MD 21619
Phone (240) 274-1377

10710 Charter Dr
Ste 400
Columbia, MD 21044
Phone (410) 997-7979

802 Landmark Dr
Ste 119
Glen Burnie, MD 21061
Phone 4107608840203

1300 York Rd
Ste 30D
Lutherville Timonium, MD 21093
Phone (443) 275-1337

205 Center St
Ste 100
Mount Airy, MD 21771

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

19455 Deerfield Ave
Ste 207
Leesburg, VA 20176
Phone (571) 399-5132

8644 Sudley Rd
#220
Manassas, VA 20110

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, 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": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1720767213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR",
            "address_2": "STE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR. STE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-8840",
            "fax_number": "410-367-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONKO",
        "first_name": "CHIARA",
        "middle_name": "ELIZABETH",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "01666",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": "2201001921",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MD",
            "license": "01666",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.