NPIMap

Individual provider Active NPI

Rafael Andres Ponce Terashima, MD

  • Infectious Disease Physician
  • Macon, GA
National Provider Identifier
1962720326
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
070409 Issued in GA
Practice address
707 Pine St
Macon, GA 31201-2106
Phone
(478) 301-5800
Fax
(478) 301-5812
NPI assigned
May 11, 2010
Last updated
Feb 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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 430109038 MI
Internal Medicine Physician 207R00000X 070409 GA
Infectious Disease Physician 207RI0200X 070409 GA Primary

Addresses

Primary practice location

707 Pine St
Macon, GA 31201-2106

Mailing address

250 Martin Luther King Jr Blvd
Macon, GA 31201
Phone (478) 301-2362

Other identifiers 1

IdentifierTypeStateIssuer
003136039MedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130729000673 GA Practitioner - Infectious DiseasePractitioner - Internal Medicine 5799926044 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

250 Martin Luther King Jr Blvd
Macon, GA 31201-3490
Phone (478) 301-4111

3920 Arkwright Rd
Suite 415
Macon, GA 31210-1731
Phone (478) 297-5190

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
430109038MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC Internal Medicine CurrentSince Apr 30, 2024 Accepting new patients
Washington County Board of Health Current Accepting new patients
Macon-Bibb County Health Department Current Accepting new patients
The Corporation of Mercer University Internal Medicine Current Accepting new patients
Twiggs Department of Public Health Current Accepting new patients
Privia Medical Group of Georgia LLC Internal Medicine CurrentSince Apr 30, 2024 Accepting new patients
Mercer Physical Therapy CurrentSince Jan 1, 2019 Accepting new patients
Crawford County Health Department Current Accepting new patients
Jones County Health Department Current Accepting new patients
Privia Medical Group, LLC Internal Medicine Past Accepting new patients
Houston County Health Department Past Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

1550 College St
Macon, GA 31207
Phone (478) 301-2600

171 Emery Hwy
Macon, GA 31217
Phone (478) 405-7220

250 Mlk Blvd
Macon, GA 31201
Phone (478) 301-2362

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rafael.ponce.terashima.1@8042.direct.athenahealth.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1962720326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-301-2362",
            "fax_number": "478-301-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 PINE ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012106",
            "telephone_number": "478-301-5800",
            "fax_number": "478-301-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE TERASHIMA",
        "first_name": "RAFAEL",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-11",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "430109038",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "070409",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "070409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136039",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.