Individual provider Active NPI

Scott Marshall Pollack, DO

  • Ophthalmology Physician
  • Williamsville, NY
National Provider Identifier
1033679212
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
310495 Issued in NY
Practice address
1630 Maple Rd Ste 100
Williamsville, NY 14221-3660
Phone
(716) 689-7330
Fax
(716) 689-6881
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Ophthalmology Physician 207W00000X 310495 NY Primary

Addresses

Primary practice location

1630 Maple Rd Ste 100
Williamsville, NY 14221-3660

Mailing address

1630 Maple Rd Ste 100
Williamsville, NY 14221-3660
Phone (716) 689-7330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230818000602 NY Practitioner - Ophthalmology 0143559716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pollack Ophthalmology Associates PLLCGroup PAC ID 8325571391, 3 clinicians

Practice addresses (Care Compare)

1630 Maple Rd
Suite 100
Williamsville, NY 14221-3660
Phone (716) 689-7330

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery134

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pollack Ophthalmology Associates PLLC Ophthalmology CurrentSince Oct 1, 2024 Accepting new patients

Locations

1630 Maple Rd
Ste 100
Williamsville, NY 14221
Phone (716) 689-7330

1630 Maple Rd
Williamsville, NY 14221
Phone (716) 689-1622

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1033679212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MAPLE RD STE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213660",
            "telephone_number": "716-689-7330",
            "fax_number": "716-689-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MAPLE RD STE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213660",
            "telephone_number": "716-689-7330",
            "fax_number": "716-689-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "SCOTT",
        "middle_name": "MARSHALL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "310495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.