NPIMap

Organization Active NPI

David S. Pomerantz MD Inc

  • Dermatology Physician
  • Pawtucket, RI
National Provider Identifier
1497780993
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DAVID S. POMERANTZ MD INC
Practice address
333 School Street
Suite 216
Pawtucket, RI 02860
Phone
(401) 728-6990
Fax
(401) 729-0930
NPI assigned
Jul 12, 2006
Last updated
May 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Authorized official

Name
David S Pomerantz, MDNPI 1972529832
Title
President
Phone
(401) 728-6990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

333 School Street
Suite 216
Pawtucket, RI 02860

Mailing address

333 School St Ste 112a
Pawtucket, RI 02860-5336
Phone (401) 728-6990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050820000148 RI Part B Supplier - Clinic/Group Practice 5890725881 Receives reassigned benefits from 9 practitioners
Practice locations: Pawtucket, RI

National Provider Directory

National Provider Directory

Locations

333 School St
Ste 112A
Pawtucket, RI 02860
Phone (401) 692-8643

333 School St
Ste 216
Pawtucket, RI 02860
Phone (401) 722-7300

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1497780993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SCHOOL ST STE 112A",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605336",
            "telephone_number": "401-728-6990",
            "fax_number": "401-729-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SCHOOL STREET",
            "address_2": "SUITE 216",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "401-728-6990",
            "fax_number": "401-729-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID S. POMERANTZ MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "POMERANTZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-728-6990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.