Individual provider Active NPI

Jack M Pomerantz, MD

  • Emergency Medicine Physician
  • Anchorage, AK
National Provider Identifier
1407842214
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
020657 Issued in LA
Practice address
3200 Providence Dr
Anchorage, AK 99508-4615
Phone
(907) 202-1736
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 020657 LA Primary

Addresses

Primary practice location

3200 Providence Dr
Anchorage, AK 99508-4615

Mailing address

Dept At952639
Atlanta, GA 31192-2639
Phone (800) 684-0857

Other practice location 1

337 E 4th Ave Unit B
Anchorage, AK 99501-2664
Phone (907) 268-6576

Other identifiers 1

IdentifierTypeStateIssuer
1903728MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.68 of 100Reported as group
Quality
84.45
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20657LAMDPharmacist
020657LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McKinley Care Medical Supplies Current Accepting new patients
Pathology LLC Current Accepting new patients
McKinley Care LLC Current Accepting new patients
Professional Emergency Physician Associates, LLC Emergency Medicine Past Accepting new patients
Gulfport Emergency Physicians Emergency Medicine Past Accepting new patients
Acs Primary Care Physicians Louisiana PC Emergency Medicine Past Accepting new patients
Keystone Medical Services of Ms, Inc Emergency Medicine Past Accepting new patients

Locations

337 E 4th Ave
Unit B
Anchorage, AK 99501
Phone (907) 268-6576

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

Organizations & group practices 7

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1407842214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT AT952639",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311922639",
            "telephone_number": "800-684-0857",
            "fax_number": "405-844-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PROVIDENCE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084615",
            "telephone_number": "907-202-1736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "337 E 4th Ave Unit B",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995012664",
            "country_code": "US",
            "telephone_number": "907-268-6576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POMERANTZ",
        "first_name": "JACK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "020657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1903728",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.