Individual provider Active NPI

Michaela Ponarski, NP

  • Family Nurse Practitioner
  • Monroe, LA
National Provider Identifier
1972297802
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
205863 Issued in LA
Practice address
2408 Broadmoor Blvd Ste B
Monroe, LA 71201-2994
Phone
(318) 807-0525
Fax
(318) 807-1077
NPI assigned
Jun 5, 2023
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 205863 LA Primary

Addresses

Primary practice location

2408 Broadmoor Blvd Ste B
Monroe, LA 71201-2994

Mailing address

130 Desiard St Ste 355
Monroe, LA 71201-7363
Phone (318) 998-3426

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230814000037 LA Practitioner - Nurse Practitioner 9335501055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisiana Pain Care, LLCGroup PAC ID 9032015607, 15 clinicians

Practice addresses (Care Compare)

210 Layton Ave
Suite 20
Monroe, LA 71210-8548
Phone (318) 323-6405

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as apm
Quality
60.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
205863LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Pain Care, LLC CurrentSince Aug 1, 2024 Accepting new patients
Louisiana Pain Care, LLC CurrentSince Aug 1, 2024 Accepting new patients
Affinity Health Group, LLC CurrentSince Jun 11, 2023 Accepting new patients
Affinity Health Group, LLC PastSince Jun 11, 2023 Accepting new patients
Arklamiss Surgery Center,LLC Past Accepting new patients

Locations

130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875

210 Layton Ave
Monroe, LA 71201
Phone (318) 323-6405

210 Layton Ave
Ste 10
Monroe, LA 71201
Phone (318) 323-6405

210 Layton Ave
Ste 20
Monroe, LA 71201
Phone (318) 323-6405

2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525

2408 Broadmoor Blvd
Ste B
Monroe, LA 71201
Phone (318) 807-0525

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: michaela.ponarskifnpc.p2@direct.lapaincare.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1972297802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DESIARD ST STE 355",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017363",
            "telephone_number": "318-998-3426",
            "fax_number": "318-812-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 BROADMOOR BLVD STE B",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012994",
            "telephone_number": "318-807-0525",
            "fax_number": "318-807-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONARSKI",
        "first_name": "MICHAELA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "205863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.