Manish Prakash Ponda, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

229346 Issued in NY

Practice address

1230 York Ave
Box 179
New York, NY 10065-6307

Phone

(917) 599-8477

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• New York University Medical Center

  • Nephrology Physician
  • New York, NY
  • NPI 1992795561
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1801945399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 E 63RD ST",
            "address_2": "APT 10P",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657912",
            "telephone_number": "917-599-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 YORK AVE",
            "address_2": "BOX 179",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656307",
            "telephone_number": "917-599-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDA",
        "first_name": "MANISH",
        "middle_name": "PRAKASH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "229346",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "229346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Edward Ponchak, PT
• Elizabeth C Ponchione, CRNP
• Arnold G. Ponciano, PTA
• Constance Sue Pond, MS IN OT, IBCLC
• Erin Pond, LMSW
• Amber Nicole Pondexter I
• Claire Gillian Poneman, LMSW
• John M Poneros, MD
• Jonathan D. Pong, DMD
• Perry Pong, MD

• Nephrology Physician in New York, NY
• Providers in New York, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.