J EDSON PONTES (MD) – Urology Physician, NPI 1285681981

J EDSON PONTES (MD) is a healthcare provider. based in Detroit, Michigan. specializing in Urology Physician. They hold the professional credentials MD. They hold a License No. 4301031303 (MI). The NPI Number for J EDSON PONTES (MD) is 1285681981

Main info

Male
62 Years Of Experience
Accepts Medicare Assignment
Name
J EDSON PONTES (MD)
NPI
1285681981
Phone
(313) 448-9006
Address
400 MACK BLVD
Enumeration Date
28 May 2006
Last Update Date
30 April 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3137454195
Graduation Year
1964 (62 years ago)
PAC ID
2062448301
Group Practice PAC ID
8628087681
Professional Enrollment ID
I20051118000125
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for J EDSON PONTES (MD)

  • Mack / Grand Blvd (EB), Mack Avenue, North Village, Detroit, Wayne County, Michigan, 48214, United States

    STE 2 WEST CREDENTIALING DEPT

    DETROIT, MI 482012153

    Phone: (313) 448-9006

    Type: Mailing

  • Wertz Clinical Cancer Center, 4100, John R Street, Medical Center, Midtown, Detroit, Wayne County, Michigan, 48201, United States

    DETROIT, MI 482012013

    Phone: (800) 527-6266

    Fax: (313) 966-8207

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-11-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20051118000125IUrologyMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628087681View full group profile
NameSpecialtyState
-MI
Nurse PractitionerMI
Cardiovascular Disease (Cardiology)MI
H O S P I T A L I S TMI
-MI
Pulmonary Disease, Internal Medicine, Critical Care (Intensivists)MI
Internal Medicine, Infectious DiseaseMI
O B S T E T R I C S/ G Y N E C O L O G YMI
Pulmonary Disease, Critical Care (Intensivists)MI
O P H T H A L M O L O G YPA

Reviews

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Frequently asked questions

Is J EDSON PONTES (MD) listed with a National Provider Identifier?
Yes — J EDSON PONTES (MD) has NPI 1285681981 on file in the registry.
Would J EDSON PONTES (MD) appear as active to a payer?
You can treat J EDSON PONTES (MD) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for J EDSON PONTES (MD)?
At a glance, J EDSON PONTES (MD) is tied to Urology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with J EDSON PONTES (MD)?
Directory geography for J EDSON PONTES (MD) centers on Detroit, Michigan.
Can I trust this NPI listing for J EDSON PONTES (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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