Amy Pollack, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6760-33 Issued in WI

Practice address

500 E Veterans St
Tomah, WI 54660-3105

Phone

(608) 372-3971

NPI assigned

Dec 17, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Tomah Memorial Hospital Inc

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1184765240
  Medicare reassignment NPD
• Tomah Memorial Hospital Inc

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1992970453
  Medicare reassignment NPD
• Tomah Memorial Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Tomah, WI
  • NPI 1205978046
  NPD

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1154786127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21997 CLAY AVE",
            "city": "WARRENS",
            "state": "WI",
            "postal_code": "546668545",
            "telephone_number": "608-387-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E VETERANS ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546603105",
            "telephone_number": "608-372-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "AMY",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6760-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angella Jean Pierce, RN
• Jessica Pierce
• Preston Pietrzak
• Jacqueline Pinter, RN
• Emily Plunk, PHARMD
• Haley Sue Pond
• Janelle R Ponder, PTA
• Tjaden McCloud Potter, CPM, LM
• Jessica Lee Prell
• Melissa Prell

• Family Nurse Practitioner in Tomah, WI
• Providers in Tomah, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.