Massara K Polus, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

P10431 Issued in ID

Practice address

999 N Curtis Rd Ste 102
Boise, ID 83706-1331

Phone

(208) 367-2167

NPI assigned

Jan 3, 2023

Last updated

Jan 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1164135224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11858 W ALBANY DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132479",
            "telephone_number": "619-456-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N CURTIS RD STE 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061331",
            "telephone_number": "208-367-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLUS",
        "first_name": "MASSARA",
        "middle_name": "K",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P10431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "P10431",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "massara.polus@saintalphonsus.org",
            "affiliation": "N",
            "address_1": "999 N Curtis Rd Ste 102",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837061331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa A Polk, F.N.P.-C
• Jacob Eldon Pollard, M.D.
• Robert Pollmann, PA-C
• Christina E Pollock, LCPC
• Jordan Pollock
• Laura Poly, PA
• Erik Charles Ponce, PHARMD
• Daniel Kenneth Pond, PA-C
• Katie Marie Pond, LCSW
• Matthew Pond, M.D.

• Pharmacist in Boise, ID
• Providers in Boise, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.