NPIMap

Individual provider Active NPI

Ever Ivan Ponciano, M.D.

  • Internal Medicine Physician
  • Hagerstown, MD
National Provider Identifier
1750572012
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D83234 Issued in MD
Practice address
354 Mill St
Hagerstown, MD 21740-6138
Phone
(301) 797-0210
NPI assigned
Aug 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0434380 KS
Student in an Organized Health Care Education/Training Program 390200000X MT191689 PA
Internal Medicine Physician 207R00000X D83234 MD Primary

Addresses

Primary practice location

354 Mill St
Hagerstown, MD 21740-6138

Mailing address

354 Mill St
Hagerstown, MD 21740-6138
Phone (301) 797-0210

Other practice location 1

1301 W 12th Ave
suite 202
Emporia, KS 66801-2587
Phone (620) 342-2521 ext. 237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170517002552 MD Practitioner - Internal Medicine 1355465923 Reassigns benefits to 2 organizations
I20240604002236 DC Practitioner - Internal Medicine 1355465923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Drexel University College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians
Primary Care Associates of Hagerstown, LLCGroup PAC ID 2264620558, 3 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

354 Mill St
Hagerstown, MD 21740-6138
Phone (301) 797-0210

Hospital & facility affiliations

  • Home Call Home health agency, Frederick, MD, CCN 217040
  • Meritus Medical Center, Inc Home health agency, Hagerstown, MD, CCN 217085
  • Hospice of the Chesapeake, Inc. Hospice, Pasadena, MD, CCN 211509
  • Hospice of the Chesapeake, Inc. Hospice, Waldorf, MD, CCN 211519
  • Hospice of Washington County, Inc Hospice, Hagerstown, MD, CCN 211511
  • Meritus Medical Center Hospital, Hagerstown, MD, CCN 210001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT191689PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Bridginglife, Inc. CurrentSince Mar 13, 2023 Accepting new patients
Primary Care Associates of Hagerstown, LLC Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Bridginglife, Inc. CurrentSince Mar 13, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Meritus Medical Laboratory LLC Past Accepting new patients

Locations

354 Mill St
Hagerstown, MD 21740
Phone (301) 739-7360

292 Stoner Ave
Westminster, MD 21157
Phone (443) 974-8725

Organizations & group practices 6

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 6

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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1750572012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 MILL ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406138",
            "telephone_number": "301-797-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 MILL ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406138",
            "telephone_number": "301-797-0210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 W 12th Ave",
            "address_2": "suite 202",
            "address_purpose": "LOCATION",
            "city": "Emporia",
            "state": "KS",
            "postal_code": "668012587",
            "country_code": "US",
            "telephone_number": "620-342-2521 x237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONCIANO",
        "first_name": "EVER",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0434380",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT191689",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D83234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.