Tom L Pooley, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D12049 Issued in MN

Practice address

124 E Walnut St
Suite 300
Mankato, MN 56001-4189

Phone

(507) 388-3384

Fax

(507) 388-6079

NPI assigned

Mar 22, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Tom L Pooley

  • Dentist
  • Mankato, MN
  • NPI 1275636615
  NPD (past) Authorized official

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1588939607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E WALNUT ST",
            "address_2": "SUITE 300",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014189",
            "telephone_number": "507-388-3384",
            "fax_number": "507-388-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E WALNUT ST",
            "address_2": "SUITE 300",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014189",
            "telephone_number": "507-388-3384",
            "fax_number": "507-388-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLEY",
        "first_name": "TOM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audra Lee Poggi, PHARM. D.
• Gabriel Gowrie Pokhai, M.D.
• Andrea M. Pollema, M.D.
• Matthew Gerald Pollema, MD
• Ashwini S Poola
• Pamela Denise Poppenhagen, RN
• Potential Health PA (Mages Chiropractic)
• Emily Anna Potter
• Rachael Suzanne Potter, O.D.
• Prairie Grace Hospice LLC

• Dentist in Mankato, MN
• Providers in Mankato, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.