Provider Demographics
NPI:1326034943
Name:PONTIOUS, JANE (DPM)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:
Last Name:PONTIOUS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22433
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2433
Mailing Address - Country:US
Mailing Address - Phone:215-777-5801
Mailing Address - Fax:215-777-5716
Practice Address - Street 1:148 N 8TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-2496
Practice Address - Country:US
Practice Address - Phone:215-777-5808
Practice Address - Fax:215-777-5825
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002925L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA231365971071OtherTRI-CARE
PA5848765OtherCIGNA
PA0076989000OtherKEYSTONE HEALTH PLAN HMO
PAP0078224OtherBLUE SHIELD OF PA
PA231365971OtherUNITED HEALTH CARE
PA31776NOtherKEYSTONE MERCY
PA231365971OtherHUMANA
PA28824OtherHEALTH PARTNERS
PA480029983OtherRAILROAD MEDICARE
PA78224OtherKEYSTONE HEALTH PLAN PPO
PA2216703OtherAETNA
PA9229OtherELDER HEALTH / BRAVO
PAP1629487OtherOXFORD
PA231365971071OtherTRI-CARE
PA9229OtherELDER HEALTH / BRAVO
PAP44243893OtherMULTI-PLAN
PAJ78224OtherINTER-CITY
PA2216703OtherAETNA
PA28824OtherHEALTH PARTNERS
PA31776NOtherKEYSTONE MERCY
PAP1629487OtherOXFORD
PA2216703OtherAETNA
PA0010727480004Medicaid