NPIMap

Individual provider Active NPI

Robert M Pollina, M.D.

  • Vascular Surgery Physician
  • Port Jefferson Station, NY
National Provider Identifier
1013988088
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
186340 Issued in NY
Practice address
1110 Hallock Ave
Port Jefferson Station, NY 11776-1210
Phone
(631) 476-9100
Fax
(631) 476-4919
NPI assigned
Jan 30, 2006
Last updated
Apr 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 186340 NY Primary

Addresses

Primary practice location

1110 Hallock Ave
Port Jefferson Station, NY 11776-1210

Mailing address

1110 Hallock Ave
Port Jefferson Station, NY 11776-1210
Phone (631) 476-9100

Other identifiers 1

IdentifierTypeStateIssuer
01658882MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091207000550 NY Practitioner - Vascular Surgery 9931205614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
State University of New York Downstate Medical Center, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Suffolk HospitalGroup PAC ID 4981508082, 94 clinicians
Suffolk Vascular Associates, PLLCGroup PAC ID 3375434582, 4 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6101

1110 Hallock Ave
Port Jefferson Station, NY 11776-1210
Phone (631) 476-9100

1149 Old Country Rd
Suite C4
Riverhead, NY 11901-2061
Phone (631) 591-9003

1324 Motor Pkwy
Suite 101
Hauppauge, NY 11749-5226
Phone (631) 979-0222

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6000

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.58 of 100Reported as group
Quality
48.65
Improvement activities
40
Cost
85.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal103
Leg revascularization (restoring blood flow)37
Removal of tissue11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
186340NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Suffolk Hospital CurrentSince Jan 5, 2023 Accepting new patients
Suffolk Vascular Associates, PLLC Vascular Surgery CurrentSince Aug 29, 2000 Accepting new patients
Central Suffolk Hosptial CurrentSince Jan 5, 2023 Accepting new patients
Suffolk Interventional Suites Inc. Past Accepting new patients

Locations

1324 Motor Pkwy
Ste 101
Islandia, NY 11749
Phone (516) 850-8143

1110 Hallock Ave
Port Jefferson Station, NY 11776
Phone (631) 476-9100

1110 Hallock Ave
#B
Port Jefferson Station, NY 11776
Phone (631) 476-9100

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: rpollina14589@direct-chsli.net
  • Direct secure messaging: rpollina69215@northwell.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1013988088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761210",
            "telephone_number": "631-476-9100",
            "fax_number": "631-476-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761210",
            "telephone_number": "631-476-9100",
            "fax_number": "631-476-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLINA",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "186340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01658882",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.