Mary Poonen, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C041790 Issued in CA

Practice address

16052 Beach Blvd
Suite 214
Huntington Beach, CA 92647-3801

Phone

(714) 544-9466

Fax

(714) 899-4275

NPI assigned

Nov 2, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.poonen@4285.securemail.prognocis.com

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.

• Mary Poonen, M.D., Inc.

  • Professional Counselor
  • Huntington Beach, CA
  • NPI 1255490157

  Psychiatry

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1780675256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 LAURELWOOD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201299",
            "telephone_number": "714-544-9466",
            "fax_number": "714-899-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16052 BEACH BLVD",
            "address_2": "SUITE 214",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473801",
            "telephone_number": "714-544-9466",
            "fax_number": "714-899-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POONEN",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C041790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Poloway, AA, BS
• Maria Ponce
• Monica Ponce
• Lisa R Ponsford, DNP
• Cassandra Poole
• Willem Andrew Porsona, BA
• Ann Porter, LMFT
• Karla Iveth Porter, RDN
• Lashauna Porter
• Sophia Portillo

• Psychiatry Physician in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.

Verify at the official NPI Registry.