Individual provider Active NPI

Larry Howard Pollack, M.D.

  • Plastic Surgery Physician
  • San Diego, CA
National Provider Identifier
1104998400
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A41696 Issued in CA
Practice address
7930 Frost St
Suite 101
San Diego, CA 92123-2737
Phone
(858) 565-7588
Fax
(858) 565-0194
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A41696 CA Primary

Addresses

Primary practice location

7930 Frost St
Suite 101
San Diego, CA 92123-2737

Mailing address

7930 Frost St
Suite 101
San Diego, CA 92123-2737
Phone (858) 565-7588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080416000684 CA Practitioner - Plastic and Reconstructive Surgery 0648292011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7910 Frost St
San Diego, CA 92123-2752
Phone (858) 565-0104

7910 Frost St
San Diego, CA 92123-2765

Hospital & facility affiliations

  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy22
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41696CAMDLicensed Psychiatric Technician
A41696CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Apr 28, 2017 Accepting new patients
San Diego General and Vascular Surgeons Medical Group, Inc. CurrentSince Nov 1, 2011 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

7910 Frost St
Ste 250
San Diego, CA 92123
Phone (858) 565-0104

7930 Frost St
Ste 101
San Diego, CA 92123
Phone (858) 492-9977

7910 Frost St
Ste 450
San Diego, CA 92123
Phone (858) 565-0104

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lpollack22342@sharphealthcare.direct-ci.com

Organizations & group practices 4

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 2

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104998400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7930 FROST ST",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232737",
            "telephone_number": "858-565-7588",
            "fax_number": "858-565-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7930 FROST ST",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232737",
            "telephone_number": "858-565-7588",
            "fax_number": "858-565-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "LARRY",
        "middle_name": "HOWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A41696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.