Individual provider Active NPI

Ryan Christopher Pollina, M.D.

  • Interventional Pain Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1255635405
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
4301092473 Issued in MI
Practice address
25311 Little Mack Ave Ste B
Saint Clair Shores, MI 48081-3301
Phone
(586) 498-2400
NPI assigned
Jan 3, 2011
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 125057079 IL
Pain Medicine Physician 208VP0000X 4301092473 MI
Interventional Pain Medicine Physician 208VP0014X 4301092473 MI Primary

Addresses

Primary practice location

25311 Little Mack Ave Ste B
Saint Clair Shores, MI 48081-3301

Mailing address

22101 Moross Rd
Suite 134, Professional Building Onc
Detroit, MI 48236-2148
Phone (313) 343-6351

Other practice location 1

22101 Moross Rd
Suite 134, Professional Building ONC
Detroit, MI 48236-2148
Phone (313) 343-6351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130402000510 MI Practitioner - Pain ManagementPractitioner - Anesthesiology 8224273818 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Wayne State University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians
Great Lakes Physiatrists PCGroup PAC ID 1153217278, 16 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

25311 Little Mack Ave
Suite B
Saint Clair Shores, MI 48081-3301
Phone 5864982400111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.92 of 100Reported as group
Quality
93.88
Improvement activities
40
Cost
69.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125057079ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water Pain Specialists PC Pain Medicine CurrentSince Apr 10, 2014 Accepting new patients
Great Lakes Physiatrists PC Pain Medicine CurrentSince Sep 1, 2020 Accepting new patients
General Hosp Medical Assoc, P.C. Past Accepting new patients

Locations

8301 Reliable Pkwy
Chicago, IL 60686

22101 Moross Rd
Ste 134
Detroit, MI 48236
Phone (313) 343-6351

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22101 Moross Rd
Ste 100
Detroit, MI 48236

5669 Lakeshore Rd
Fort Gratiot, MI 48059
Phone (810) 385-7260

17700 23 Mile Rd
Macomb, MI 48044
Phone (586) 416-7500

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

50505 Schoenherr Rd
Ste 200
Shelby Township, MI 48315
Phone (586) 803-1220

25311 Little Mack Ave
Ste B
St Clr Shores, MI 48081
Phone (586) 498-2400

21000 E 12 Mile Rd
St Clr Shores, MI 48081
Phone (586) 447-5000

Interoperability endpoints

  • Direct secure messaging: rpollina994707@direct.hfhs.org

Organizations & group practices 4

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 8

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": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1255635405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "address_2": "SUITE 134, PROFESSIONAL BUILDING ONC",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-6351",
            "fax_number": "313-417-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25311 LITTLE MACK AVE STE B",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813301",
            "telephone_number": "586-498-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22101 Moross Rd",
            "address_2": "Suite 134, Professional Building ONC",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362148",
            "country_code": "US",
            "telephone_number": "313-343-6351",
            "fax_number": "313-417-0527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLINA",
        "first_name": "RYAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-03",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125057079",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MI",
            "license": "4301092473",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MI",
            "license": "4301092473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.