Kyle Jude Pontiff, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

207988 Issued in LA

Practice address

8200 Constantin Blvd FL 1
Baton Rouge, LA 70809-3481

Phone

(225) 765-5500

Fax

(225) 374-1670

NPI assigned

Jul 12, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943

  Pediatrics

  Medicare reassignment NPD
• Our Lady of the Lake Physician Group LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD
• Our Lady of the Lake Physician Group LLC

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455
  NPD (past)

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1902161177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 CONSTANTIN BLVD FL 1",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093481",
            "telephone_number": "225-765-5500",
            "fax_number": "225-374-1670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "848 Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032816",
            "country_code": "US",
            "telephone_number": "901-287-6112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372322816",
            "country_code": "US",
            "telephone_number": "615-322-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 Gillham Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641084619",
            "country_code": "US",
            "telephone_number": "816-234-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5959 S Sherwood Forest Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708166038",
            "country_code": "US",
            "telephone_number": "225-343-9505",
            "fax_number": "225-343-9171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONTIFF",
        "first_name": "KYLE",
        "middle_name": "JUDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "54631",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "MO",
            "license": "2020020214",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "GETP.200986",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "207988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Stephen Pollet, MD
• Stephen Pollet, MD
• Ashok Reddy Polu, M.D.
• Sarah Ponder, PAC
• Kristen Lee Pontiff, MD
• Jennifer Dupuy Pontti, RNFA
• Jordyn Ponvelle
• Jenae Ventress Poole, FNP-C
• Lakeitha Poole, PHD, LPC, NCC
• Lynell Shawn Poole

• Pediatrics Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; 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.