Individual provider Active NPI

David Poulad, M.D.

  • Neurological Surgery Physician
  • Union, NJ
National Provider Identifier
1184695090
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MA07915000 Issued in NJ
Practice address
1057 Commerce Ave
Union, NJ 07083-5025
Phone
(908) 688-8800
Fax
(908) 688-2377
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MA07915000 NJ Primary

Addresses

Primary practice location

1057 Commerce Ave
Union, NJ 07083-5025

Mailing address

1057 Commerce Ave
Union, NJ 07083-5025
Phone (908) 688-8800

Other identifiers 1

IdentifierTypeStateIssuer
0073873MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050705000304 NJ Practitioner - Neurosurgery 2466498407 Reassigns benefits to 1 organization
I20180615000508 NY Practitioner - Neurosurgery 2466498407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Saint Louis University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Igea Brain and Spine,PAGroup PAC ID 2769418037, 18 clinicians

Practice addresses (Care Compare)

1057 Commerce Ave
Union, NJ 07083-5025
Phone (908) 688-8800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.34 of 100Reported as group
Quality
43.74
Improvement activities
40
Cost
66.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion39
Laminectomy or laminotomy (partial removal of spine bones)12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA07915000NJMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Neurosurgical Associates Neurological Surgery CurrentSince Apr 7, 2015 Accepting new patients

Locations

1057 Commerce Ave
Union, NJ 07083
Phone (866) 467-1770

Organizations & group practices 3

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 5

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1184695090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 COMMERCE AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835025",
            "telephone_number": "908-688-8800",
            "fax_number": "908-688-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 COMMERCE AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835025",
            "telephone_number": "908-688-8800",
            "fax_number": "908-688-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULAD",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "MA07915000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073873",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.