Ernest Keith Polk, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

C39853 Issued in CA

Practice address

100 W California Blvd
Pasadena, CA 91105-3010

Phone

(626) 397-5000

Fax

(626) 397-2912

NPI assigned

Jul 26, 2006

Last updated

Aug 3, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Pacific Valley Medical Group

  • Anesthesiology Physician
  • Pasadena, CA
  • NPI 1851312862
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1114941051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N ALMANSOR ST",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011127",
            "telephone_number": "626-289-7419",
            "fax_number": "626-289-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "626-397-5000",
            "fax_number": "626-397-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "ERNEST",
        "middle_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C39853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00C398530",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C398530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacklin Poladian, M.D.
• Alexandra Ann Polak
• Katherine Poland, MS, LMFT
• Polito Physical Therapy, Inc.
• Stephen Christopher Polito, P.T.
• Joshua A Polk
• Noelle Polk
• Harvey Anton Pollack, MS, MD
• Marla Pollack, PH.D.
• Juliette Verdell Pollard, L.V.N.

• Anesthesiology Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.