Mario C Ponce Jr, PT is a medicare enrolled "Physical Therapist" provider in Rochester, Indiana. His current practice location is
1729 Wabash Ave, Rochester, Indiana. You can reach out to his office (for appointments etc.) via phone at
(574) 475-8518.
Mario C Ponce Jr is licensed to practice in Indiana (license number 05004455A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1760199491.
Healthcare Provider's Profile
Full Name | Mario C Ponce Jr |
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Gender | Male |
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Speciality | Physical Therapist |
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Location | 1729 Wabash Ave, Rochester, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1760199491
- Provider Enumeration Date: 11/02/2022
- Last Update Date: 11/02/2022
Medicare PECOS Information:
- PECOS PAC ID: 7214305812
- Enrollment ID: I20221201000534
Medical Identifiers
Medical identifiers for Mario C Ponce Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1760199491 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | 05004455A (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mario C Ponce Jr allows following entities to bill medicare on his behalf.
Provider Name | Aegis Group Practice Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1083227169 PECOS PAC ID: 5193036432 Enrollment ID: O20201023002377 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mario C Ponce Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
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 |
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