Individual provider Active NPI

Jessica Ball Pollom, CRNA

  • Certified Registered Nurse Anesthetist
  • San Diego, CA
National Provider Identifier
1487135760
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95001505 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Aug 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 756989 NY
Certified Registered Nurse Anesthetist 367500000X NA95001505 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (800) 926-8273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190112000028 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628314630 Reassigns benefits to 1 organization
I20210618000579 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628314630 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Gabriel Anesthesia Associates, PCGroup PAC ID 3678720604, 16 clinicians
Samantha Polikowski Anesthesia IncGroup PAC ID 1951742543, 36 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

44139 Monterey Ave
Suite B
Palm Desert, CA 92260-8700
Phone (760) 779-5599

835 3Rd Ave
Suite a
Chula Vista, CA 91911-1352
Phone (619) 425-7755

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95001505CAMDFamily Nurse Practitioner
NA95001505CAMDCertified Registered Nurse Anesthetist
756989NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
San Gabriel Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince May 30, 2024 Accepting new patients
New York University CurrentSince Jan 1, 2019 Accepting new patients
Concierge Anesthesia CurrentSince Jun 1, 2024 Accepting new patients
Regents of the University of California CurrentSince Jun 1, 2021 Accepting new patients
New York University Current Accepting new patients
Samantha Polikowski Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2024 Accepting new patients
Regents of the University of California Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2021 Accepting new patients
New York University CurrentSince Jan 1, 2019 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Heart of San Diego Surgical Center LLC PastSince Jun 18, 2023 Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

288 N Santa Anita Ave
Ste 404
Arcadia, CA 91006
Phone (626) 289-2223

835 Third Ave
Ste A
Chula Vista, CA 91911
Phone (619) 425-7755

835 Third Ave
Chula Vista, CA 91911
Phone (619) 409-1600

700 W El Norte Pkwy
Escondido, CA 92026
Phone (760) 738-7830

488 E Valley Pkwy
Ste 100
Escondido, CA 92025
Phone (760) 546-4386

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

25405 Hancock Ave
Ste 103
Murrieta, CA 92562
Phone (909) 698-4670

3903 Waring Rd
Oceanside, CA 92056
Phone (760) 724-3293

44139 Monterey Ave
Ste B
Palm Desert, CA 92260
Phone (760) 773-4411

3939 Ruffin Rd
San Diego, CA 92123
Phone (619) 299-9530

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

8705 Complex Dr
Ste 202
San Diego, CA 92123
Phone (858) 302-2502

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

3939 3rd Ave
San Diego, CA 92103
Phone (619) 296-8525

816 E Enos Dr
Ste B
Santa Maria, CA 93454
Phone (805) 347-7813

4472 Broad St
Ste 150
Sn Luis Obisp, CA 93401
Phone (805) 364-8450

41900 Winchester Rd
Temecula, CA 92590

3180 Willow Ln
Ste 118
Thousand Oaks, CA 91361
Phone (805) 766-6319

696 Hampshire Rd
Ste 100
Westlake Vlg, CA 91361
Phone (805) 413-7920

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 11

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 1

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": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1487135760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "800-926-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOM",
        "first_name": "JESSICA",
        "middle_name": "BALL",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "756989",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95001505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.