| Mario C Ponce Jr, PT | |
|
1729 Wabash Ave, Rochester, IN 46975-2455 | |
| (574) 475-8518 | |
| Not Available |
| Full Name | Mario C Ponce Jr |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 33 Years |
| Location | 1729 Wabash Ave, Rochester, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760199491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 05004455A (Indiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aegis Group Practice Llc | 5193036432 | 404 |
| Provider Name | Aegis Group Practice Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1083227169 PECOS PAC ID: 5193036432 Enrollment ID: O20201023002377 |
| Mailing Address | Practice Location Address |
|---|---|
| Mario C Ponce Jr, PT 1313 Rochester Blvd, Rochester, IN 46975 Ph: (574) 201-9975 | Mario C Ponce Jr, PT 1729 Wabash Ave, Rochester, IN 46975-2455 Ph: (574) 475-8518 |
Derrek Freshour, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 827 W 13th St, Rochester, IN 46975 Phone: 574-223-4331 | |
Bradley Marshaall Rogers, PT, MPA, MPM, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1400 E 9th St, Rochester, IN 46975 Phone: 574-224-1166 | |
Aegis Group Practice Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1729 Wabash Ave, Rochester, IN 46975 Phone: 800-444-6845 |