Individual provider Active NPI

Kyrstin Pontes

  • Physician Assistant
  • West Columbia, SC
National Provider Identifier
1750002390
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4699 Issued in SC
Practice address
2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone
(803) 791-2350
Fax
(803) 791-2520
NPI assigned
Sep 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 029088 NY
Physician Assistant 363A00000X 4699 SC Primary

Addresses

Primary practice location

2720 Sunset Blvd
West Columbia, SC 29169-4810

Mailing address

PO Box 6069
West Columbia, SC 29171-6069
Phone (803) 791-2350

Other practice location 1

211 E 51st St
New York, NY 10022-6526
Phone (332) 263-4467

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kpontes177445@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240724003689 SC Practitioner - Physician Assistant 7517403652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

1111 Knox Abbott Dr
Cayce, SC 29033-3323
Phone (803) 314-0660

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2460

811 W Main St
Lexington, SC 29072-2500

Hospital & facility affiliations

  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
029088NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc CurrentSince Aug 1, 2024 Accepting new patients
Lexington Health Inc CurrentSince Aug 1, 2024 Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

1111 Knox Abbott Dr
Cayce, SC 29033
Phone (803) 314-0660

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1750002390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-791-2350",
            "fax_number": "803-791-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694810",
            "telephone_number": "803-791-2350",
            "fax_number": "803-791-2520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 E 51st St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100226526",
            "country_code": "US",
            "telephone_number": "332-263-4467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONTES",
        "first_name": "KYRSTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029088",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpontes177445@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2720 Sunset Blvd",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.