Ruben Pollak, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DP00368 Issued in OR

Practice address

1369 N 10TH Ave
Stayton, OR 97383-2037

Phone

(503) 769-7960

Fax

(503) 769-9860

NPI assigned

Jul 8, 2005

Reactivated

May 10, 2006

Last updated

Feb 15, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santiam Hospital & Clinics Hospital, Stayton, OR, CCN 380056

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpollak@santiam.securechart.com

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.

• Santiam Memorial Hospital

  • General Acute Care Hospital
  • Stayton, OR
  • NPI 1154302214
  Medicare reassignment Care Compare group
• Ruben Pollak, DPM, PC

  • Podiatrist
  • Stayton, OR
  • NPI 1417126434
  Authorized official Same address or phone
• Santiam Memorial Hospital

  dba Santiam General Surgery

  • Medical Specialty Clinic/Center
  • Stayton, OR
  • NPI 1396152351
  NPD
• John T. Callahan, DPM

  dba Santiam Foot Clinic

  • Podiatrist
  • Salem, OR
  • NPI 1114199361
  NPD (past)
• Santiam Foot Clinic, PC

  • Podiatrist
  • Salem, OR
  • NPI 1528395043
  NPD (past)
• Santiam Memorial Hospital

  dba Santiam Podiatry Clinic

  • Podiatric Clinic/Center
  • Stayton, OR
  • NPI 1912413147
  NPD (past)
• Santiam Orthopaedics LLC

  • Specialist
  • Stayton, OR
  • NPI 1487770483
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Santiam Memorial Hospital

  • General Acute Care Hospital
  • Stayton, OR
  • NPI 1154302214
  Care Compare affiliation
• Santiam Memorial Hospital

  • Ambulance
  • Stayton, OR
  • NPI 1962566752

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1306844022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1369 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "97383",
            "telephone_number": "503-769-7960",
            "fax_number": "503-769-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1369 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973832037",
            "telephone_number": "503-769-7960",
            "fax_number": "503-769-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLAK",
        "first_name": "RUBEN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2017-02-15",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271049",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE DMERC",
            "identifier": "4020070001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larrie Allen Pattyn, THW, CHW
• Paul J. Neumann, MD, PC
• Jovana Pazin, DPT, PT
• Physical Therapy Northwest Limited Partnership
• Everett Plocek, DPT
• Holly Elise Pomme, MSW, LCSW
• Kelsey Marie Porter, PA-C
• Racheal Prisco, PSS,CRM
• Promotion Advanced Functional Rehab LLC (ProMotion Physical Therapy)
• Tiffanie Ann Pye, PHARMD, BCPS

• Podiatrist in Stayton, OR
• Providers in Stayton, OR by specialty
• Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.