Individual provider Active NPI

Chava Pollak, FNP

  • Family Nurse Practitioner
  • Monsey, NY
National Provider Identifier
1174020093
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341405 Issued in NY
Practice address
92 Edison CT
Monsey, NY 10952-1938
Phone
(845) 499-7985
NPI assigned
Apr 8, 2018
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 341405 NY Primary

Addresses

Primary practice location

92 Edison CT
Monsey, NY 10952-1938

Mailing address

40 S Main St
Ste 1300
Memphis, TN 38103-5513
Phone (901) 422-7617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20190430001430 NY Practitioner - Nurse Practitioner 5698017333 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
341405NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Post Road Medical Services PC CurrentSince Apr 1, 2019 Accepting new patients

Locations

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1174020093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 S MAIN ST",
            "address_2": "STE 1300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381035513",
            "telephone_number": "901-422-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 EDISON CT",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109521938",
            "telephone_number": "845-499-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLAK",
        "first_name": "CHAVA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-08",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monsey, NY

Sources for this page

Verify at the official NPI Registry.