DR. AMANDA JEAN PETTIBONE-POND M.D.
NPI 1790075596
Urology in Bloomington, IN

Q: What is Amanda Pettibone-pond's NPI number?

The NPI number for Amanda Pettibone-pond is 1790075596. It was assigned to this individual provider in the NPPES registry on April 13, 2011.

Q: What is Amanda Pettibone-pond's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Active since April 13, 2011PECOS EnrolledAccepts Medicare Assignment

98.33/100

CMS Quality Rating

1520 S LIBERTY DR, BLOOMINGTON, IN 47403(812) 676-4500(812) 676-4501 Get Directions Write a Review

NPPES record last updated: July 6, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Amanda Jean Pettibone-pond M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AMANDA JEAN PETTIBONE-POND M.D. (NPI 1790075596) is an individual urology provider in Bloomington, Indiana, licensed in Indiana (01076608A) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS, is affiliated with Ecu Health Medical Center, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1790075596

Entity TypeIndividualFemale

Primary Taxonomy208800000X

Provider Legal NameDR. AMANDA JEAN PETTIBONE-PONDCredential: M.D.

Location Address1520 S LIBERTY DRBloomington, IN 47403-5167

Mailing Address1520 S Liberty DrBloomington, IN 47403-5167 · (812) 353-3087

Phone(812) 676-4500

Fax(812) 676-4501

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateApril 13, 2011

Last NPPES UpdateJuly 6, 2016

✔ NPI 1790075596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in IN · 01076608A

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

1520 S LIBERTY DR, Bloomington, IN 47403

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, CareSource, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Amanda Jean Pettibone-pond M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628214293

PECOS Enrollment IDI20200514002295

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 23

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

895 services524 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

349 services255 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

293 services224 patients

Leuprolide acetate (for depot suspension), 7.5 mg J9217

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

163 services23 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

161 services145 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

147 services124 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

85 services23 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

65 services64 patients

Ultrasonic guidance for needle placement 76942

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

64 services59 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

64 services64 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

60 services60 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

37 services37 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

33 services29 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

32 services32 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

32 services23 patients

Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies L8606

An injectable bulking agent is a synthetic implant used to improve the function of your urinary tract. It's administered via a 1 ml syringe. The cost includes shipping and all necessary supplies. It's a common, non-invasive procedure to enhance urinary control.

26 services12 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

24 services20 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

24 services22 patients

Removal of prostate gland using an electrocautery knife through urethra with control of bleeding using an endoscope 52601

This procedure involves the careful removal of a small gland located in the lower body using a special heated knife, inserted through a natural body passage. An endoscope, a thin tube with a light and camera, helps to manage any bleeding. The aim is to alleviate discomfort and improve overall health.

19 services19 patients

Diagnostic exam of bladder, urethra, and ureter or kidney using an endoscope 52351

This is a procedure where a small tube with a camera, called an endoscope, is used to examine the bladder and the tubes that carry urine from the kidneys to the bladder. It helps in detecting any abnormalities or issues.

14 services13 patients

Injection of implant material beneath lining of bladder and/or urethra using an endoscope 51715

This is a procedure where a substance is inserted under the bladder or urethra lining using a special instrument called an endoscope. This helps to support these areas and improve their function. It's done in a safe, controlled medical environment.

13 services12 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

13 services13 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ecu Health Medical Center

Acute Care Hospitals · Greenville, NC

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340040

Location2100 Stantonsburg RdGreenville, NC 27834 · Pitt County

Emergency services Birthing friendly

Sentara Albemarle Medical Center

Acute Care Hospitals · Elizabeth City, NC

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number340109

Location1144 N Road StElizabeth City, NC 27909 · Pasquotank County

Emergency services Birthing friendly

Vidant Chowan Hospital

Critical Access Hospitals · Edenton, NC

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number341318

Location211 Virginia RdEdenton, NC 27932 · Chowan County

Emergency services Birthing friendly

The Outer Banks Hospital, Inc

Critical Access Hospitals · Nags Head, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number341324

Location4800 South Croatan HighwayNags Head, NC 27959 · Dare County

Emergency services Birthing friendly

Chesapeake General Hospital

Acute Care Hospitals · Chesapeake, VA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number490120

Location736 Battlefield Blvd, NorthChesapeake, VA 23320 · Chesapeake City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.33/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.93

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lubricant, individual sterile packet, each A4332

DME-Medical/Surgical Supplies · category DA000N

1 supplier14 claims1,420 services$0.09 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

3 suppliers41 claims10,320 services$1.47 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

3 suppliers58 claims5,390 services$5.83 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEVERLY J SHAMLOO NP

Nurse Practitioner