Individual provider Active NPI

Barry J Pollack, MD

  • Neurological Surgery Physician
  • Independence, MO
National Provider Identifier
1053374835
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2017000597 Issued in MO
Practice address
19550 E 39TH St S Ste 105
Independence, MO 64057-1926
Phone
(816) 350-4215
Fax
(816) 350-4220
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 225485 NY
Neurological Surgery Physician 207T00000X 2017000597 MO Primary

Addresses

Primary practice location

19550 E 39TH St S Ste 105
Independence, MO 64057-1926

Mailing address

19550 E 39TH St S Ste 105
Independence, MO 64057-1926
Phone (816) 350-4215

Other identifiers 1

IdentifierTypeStateIssuer
1053374835MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address BARRY.POLLACK@hca2.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170222000828 MO Practitioner - Neurosurgery 2769464734 Reassigns benefits to 1 organization
I20200120000243 KS Practitioner - Neurosurgery 2769464734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerpoint Medical Specialists LLCGroup PAC ID 6800912064, 5 clinicians

Practice addresses (Care Compare)

19550 E 39TH St S
Suite 105
Independence, MO 64057-1926
Phone (816) 350-4215

Hospital & facility affiliations

  • Centerpoint Medical Center Hospital, Independence, MO, CCN 260095

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion16
Laminectomy or laminotomy (partial removal of spine bones)1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Networks

  • IA HMO
  • IA HMO C-SNP

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1053374835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S STE 105",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571926",
            "telephone_number": "816-350-4215",
            "fax_number": "816-350-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S STE 105",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571926",
            "telephone_number": "816-350-4215",
            "fax_number": "816-350-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "BARRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-01-27",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "225485",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2017000597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053374835",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BARRY.POLLACK@hca2.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "19550 E 39th St S Ste 105",
            "city": "Independence",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640571926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.