Individual provider Active NPI

Kelly Ann Pollak, M.D.

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1275770463
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01100357A Issued in IN
Practice address
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone
(317) 962-8880
NPI assigned
Jan 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD174707 OR
Pain Medicine (Anesthesiology) Physician 207LP2900X MD60375352 WA
Pain Medicine (Anesthesiology) Physician 207LP2900X 01100357A IN
Anesthesiology Physician 207L00000X 01100357A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

707 SW Washington St
Suite 700
Portland, OR 97205-3536
Phone (503) 299-9906

Other identifiers 3

IdentifierTypeStateIssuer
1275770463MedicaidWA
500707623MedicaidOR
300132919MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kpollak@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 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
I20130619000569 WA Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 3870732076 Reassigns benefits to 1 organization
I20160318000692 OR Practitioner - Anesthesiology 3870732076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Anesthesiology Group PCGroup PAC ID 3476451659, 239 clinicians

Practice addresses (Care Compare)

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone (360) 487-1000

707 SW Washington St
Suite 700
Portland, OR 97205-3523
Phone (503) 299-9906

Hospital & facility affiliations

  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Anesthesiology Group PC Anesthesiology CurrentSince Jan 28, 2016 Accepting new patients
Oag Trauma Services LLC Anesthesiology PastSince Jan 28, 2016 Accepting new patients

Locations

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

707 SW Washington St
Ste 700
Portland, OR 97205

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1275770463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-8880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 SW Washington St",
            "address_2": "Suite 700",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972053536",
            "country_code": "US",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLAK",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD174707",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "MD60375352",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "01100357A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01100357A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275770463",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500707623",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300132919",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpollak@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.