Raymond M Pongonis, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

34.003156 Issued in OH

Practice address

3900 Stoneridge LN Ste C
Dublin, OH 43017-2289

Phone

(614) 366-9324

Fax

(614) 366-9339

NPI assigned

Dec 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Interoperability endpoints

• Direct secure messaging: rpongonis9246@direct.osumc.edu

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.

• Max Sports Medicine Institute, Inc

  • Clinic/Center
  • Columbus, OH
  • NPI 1417020298
  NPD (past)
• Osu Sports Medicine Center

  • Sports Medicine (Family Medicine) Physician
  • Columbus, OH
  • NPI 1285692228
  NPD (past)

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1922085596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-9324",
            "fax_number": "614-293-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 STONERIDGE LN STE C",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430172289",
            "telephone_number": "614-366-9324",
            "fax_number": "614-366-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONGONIS",
        "first_name": "RAYMOND",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "34.003156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0461950",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpongonis9246@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "3900 Stoneridge Ln Ste C",
            "city": "Dublin",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430172289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeff Brian Polzin, RPH
• BJ Pomerants, MD
• Elijah Ponce, RBT
• Pond Medical Center Inc.
• David W Pond, D.O.
• Morgan Poppenga, RBT
• Nora Pore
• Katelyn Porter
• Lee Ann Porter
• Seyauna Desiree Porter, LMT

• Sports Medicine (Family Medicine) Physician in Dublin, OH
• Providers in Dublin, OH by specialty
• Sports Medicine (Family Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.