Individual provider Active NPI

Martine R Pollack-Zollman

  • Nephrology Physician
  • New York, NY
National Provider Identifier
1366717613
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
279502 Issued in NY
Practice address
353 E 17TH St
2ND Floor, Room 223
New York, NY 10003-3821
Phone
(212) 420-3743
NPI assigned
Mar 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X 279502 NY Primary

Addresses

Primary practice location

353 E 17TH St
2ND Floor, Room 223
New York, NY 10003-3821

Mailing address

353 E 17TH St
2ND Floor, Room 223
New York, NY 10003-3821
Phone (212) 420-3743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170622001330 NY Practitioner - Nephrology 9931477569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Albert Einstein College of Medicine of Yeshiva University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

440 W 114TH St
New York, NY 10025-1796
Phone (212) 523-8672

5 E 98TH St
New York, NY 10029-6501
Phone (212) 241-4060

Hospital & facility affiliations

  • Park Avenue Dialysis Center LLC Dialysis facility, New York, NY, CCN 332727
  • FMC Avantus Harlem Green Dialysis Dialysis facility, New York, NY, CCN 332706
  • FMC Avantus Upper Manhattan Dialysis Center Dialysis facility, New York, NY, CCN 332699
  • Mount Sinai West Hospital, New York, NY, CCN 330046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Nephrology CurrentSince Nov 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

36 W 60th St
New York, NY 10023
Phone (212) 265-2828

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

1090 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2211

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 6

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 4

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1366717613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 E 17TH ST",
            "address_2": "2ND FLOOR, ROOM 223",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033821",
            "telephone_number": "212-420-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 E 17TH ST",
            "address_2": "2ND FLOOR, ROOM 223",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033821",
            "telephone_number": "212-420-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK-ZOLLMAN",
        "first_name": "MARTINE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "279502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.