NPIMap

Individual provider Active NPI

Matthew R. Pollack, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Columbia, SC
National Provider Identifier
1437230364
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
28866 Issued in SC
Practice address
2 Medical Park Rd
Suite 104
Columbia, SC 29203-6875
Phone
(803) 434-6781
Fax
(803) 434-8377
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28866 SC
Sports Medicine (Family Medicine) Physician 207QS0010X 28866 SC Primary

Addresses

Primary practice location

2 Medical Park Rd
Suite 104
Columbia, SC 29203-6875

Mailing address

PO Box 22265
Belfast, ME 04915-4473
Phone (803) 296-7846

Other practice location 1

2 Medical Park Rd
Suite 104
Columbia, SC 29203-6875
Phone (803) 434-6781

Other identifiers 3

IdentifierTypeStateIssuer
P00883441OtherSCRR MEDICARE ID
PA4646MedicaidSC
288664MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101228000051 SC Practitioner - Family PracticePractitioner - Sports Medicine 0749334217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

14 Richland Medical Park Dr
Suite 200
Columbia, SC 29203-6882
Phone (803) 296-7846

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28866SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Feb 1, 2018 Accepting new patients
Prisma Health Medical Group-Midlands Family Medicine Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Feb 1, 2018 Accepting new patients
Andrews Sports Medicine and Orthopaedic Center Past Accepting new patients
Gray'S Pain Relief Center, LLC Past Accepting new patients
Advantage Healthcare of Charleston LLC PastSince Jan 31, 2011 Accepting new patients

Locations

2 Medical Park Rd
Ste 104
Columbia, SC 29203
Phone (803) 434-6781

14 Richland Medical Park Dr
Ste 200
Columbia, SC 29203
Phone (803) 296-9200

104 Saluda Pointe Dr
Lexington, SC 29072
Phone (803) 296-9200

Interoperability endpoints

  • Direct secure messaging: mpollack383411@direct.ghs.myhfn.org

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 11

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1437230364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22265",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154473",
            "telephone_number": "803-296-7846",
            "fax_number": "803-296-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD",
            "address_2": "SUITE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036875",
            "telephone_number": "803-434-6781",
            "fax_number": "803-434-8377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Medical Park Rd",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036875",
            "country_code": "US",
            "telephone_number": "803-434-6781",
            "fax_number": "803-434-8377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "MATTHEW",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "28866",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "SC",
            "license": "28866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE ID",
            "identifier": "P00883441",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA4646",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288664",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.