Individual provider Active NPI

Kerri Pollack, PA

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1164454963
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114481 Issued in FL
Practice address
8931 Colonial Center Dr Ste 400
Fort Myers, FL 33905-7809
Phone
(239) 334-6626
Fax
(239) 334-0404
NPI assigned
Jul 6, 2006
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9114481 FL Primary

Addresses

Primary practice location

8931 Colonial Center Dr Ste 400
Fort Myers, FL 33905-7809

Mailing address

4130 1St Ave SW
Naples, FL 34119-2641
Phone (516) 263-4485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040520001090 NY Practitioner - Physician Assistant 3870584618 Reassigns benefits to 1 organization
I20240702001313 FL Practitioner - Physician Assistant 3870584618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

11190 Health Park Blvd
Naples, FL 34110-5729
Phone (239) 552-7000

350 7TH St N
Naples, FL 34102-5754

680 2ND Ave N
Suite 304
Naples, FL 34102-5757
Phone (239) 261-7711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9114481FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd, Inc CurrentSince Sep 3, 2025 Accepting new patients
New York University CurrentSince May 1, 2021 Accepting new patients
New York University CurrentSince May 1, 2021 Accepting new patients
Genesiscare USA of Florida LLC CurrentSince May 20, 2024 Accepting new patients
21St Century Oncology LLC CurrentSince May 20, 2024 Accepting new patients
Landmark Hospital of Southwest Florida, LLC CurrentSince Sep 3, 2025 Accepting new patients
Genesiscare USA of Florida LLC Past Accepting new patients
Nchmd Inc Past Accepting new patients

Locations

8925 Colonial Center Dr
Ste 1001
Fort Myers, FL 33905
Phone (239) 343-5864

8931 Colonial Center Dr
Ste 400
Fort Myers, FL 33905
Phone (239) 319-3714

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kpollack113771@nchhealthcaresystem.direct-ci.com
  • Direct secure messaging: kpollack283378@nyumc.direct-ci.com

Organizations & group practices 9

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.

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1164454963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 1ST AVE SW",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341192641",
            "telephone_number": "516-263-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 COLONIAL CENTER DR STE 400",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057809",
            "telephone_number": "239-334-6626",
            "fax_number": "239-334-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "KERRI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.