Individual provider Active NPI

Jared Thomas Poland, AUD

  • Audiologist
  • Albuquerque, NM
National Provider Identifier
1285268193
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD7079 Issued in NM
Practice address
2211 Lomas Blvd NE # 5N
Albuquerque, NM 87106-2719
Phone
(505) 272-3535
Fax
(505) 272-0300
NPI assigned
Feb 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD7079 NM Primary

Addresses

Primary practice location

2211 Lomas Blvd NE # 5N
Albuquerque, NM 87106-2719

Mailing address

2211 Lomas Blvd NE # 5N
Albuquerque, NM 87106-2719
Phone (505) 272-3535

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200908000414 NM Practitioner - Qualified Audiologist 1557788536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unm HospitalGroup PAC ID 7618889528, 394 clinicians

Practice addresses (Care Compare)

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2644

Merit-based Incentive Payment System (MIPS)

Final score
91.83 of 100Reported as group
Quality
83.58
Promoting interoperability
100
Improvement activities
40
Cost
72.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD7079NMMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Hospital CurrentSince Aug 13, 2020 Accepting new patients
Unm Hospital CurrentSince Aug 13, 2020 Accepting new patients
DCLC Enterprises, LLC Audiologist PastSince Mar 1, 2020 Accepting new patients
Wondearfully Audacious, LLC PastSince Mar 1, 2020 Accepting new patients

Locations

400 Tijeras Ave NW
Ste 450
Albuquerque, NM 87102
Phone (505) 272-0148

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1285268193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE # 5N",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-3535",
            "fax_number": "505-272-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE # 5N",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-3535",
            "fax_number": "505-272-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAND",
        "first_name": "JARED",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-29",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NM",
            "license": "AUD7079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE # 5N",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.