NPIMap

Individual provider Active NPI

Pooja Gottumukkala Haas

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1609455369
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
010795 Issued in AZ
Practice address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone
(602) 812-3122
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 010795 AZ Primary

Addresses

Primary practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

4001 N 3Rd St Ste 290
Phoenix, AZ 85012-2071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240711003630 AZ Practitioner - Emergency Medicine 0547705733 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Professional Services PCGroup PAC ID 6901707272, 107 clinicians
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (954) 939-5000

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
  • Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115
  • Valleywise Health Medical Center Hospital, Phoenix, AZ, CCN 030022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010795AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Current Accepting new patients
Community Hospital Association, Inc. CurrentSince Sep 1, 2024 Accepting new patients
District Medical Group, Inc CurrentSince Nov 1, 2024 Accepting new patients
Emergency Professional Services PC Emergency Medicine CurrentSince Jun 3, 2024 Accepting new patients
District Medical Group, Inc Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients
Emergency Physicians Southwest, PC Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
Emergency Professional Services PC Emergency Medicine CurrentSince Jun 3, 2024 Accepting new patients
Innova Emergency Medical Associates PC Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Community Hospital Association, Inc. CurrentSince Sep 1, 2024 Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

523 Rose Ln
Wickenburg, AZ 85390
Phone (928) 668-1833

520 Rose Ln
Wickenburg, AZ 85390
Phone (928) 666-1197

Interoperability endpoints

  • Direct secure messaging: phaas232764@direct.valleywisehealth.org

Organizations & group practices 9

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1609455369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 N 3RD ST STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-812-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "POOJA",
        "middle_name": "GOTTUMUKKALA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "010795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.