Individual provider Active NPI

Emmily Jane Poole, M.D.

  • Pulmonary Disease Physician
  • Clovis, CA
National Provider Identifier
1518320456
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A159552 Issued in CA
Practice address
2755 Herndon Ave
Clovis, CA 93611-6800
Phone
(559) 324-4026
Fax
(559) 324-3730
NPI assigned
Mar 29, 2016
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A159552 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A159552 CA
Pulmonary Disease Physician 207RP1001X A159552 CA Primary

Addresses

Primary practice location

2755 Herndon Ave
Clovis, CA 93611-6800

Mailing address

217 7TH St
Clovis, CA 93612-1844
Phone (858) 231-5095

Other names 1

  • Dr. Emma Jane Tkach Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190909000695 CA Practitioner - Internal MedicinePractitioner - Pulmonary Disease 1557690104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2755 Herndon Ave
Clovis, CA 93611-6800
Phone (559) 228-4327

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
87.02
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A159552CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group Internal Medicine CurrentSince Aug 11, 2023 Accepting new patients
Community Foundation Medical Group CurrentSince Aug 11, 2023 Accepting new patients
Community Foundation Medical Group Internal Medicine Current Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1518320456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 7TH ST",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936121844",
            "telephone_number": "858-231-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116800",
            "telephone_number": "559-324-4026",
            "fax_number": "559-324-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "EMMILY",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2024-08-06",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A159552",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A159552",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A159552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "TKACH",
            "middle_name": "JANE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.