Individual provider Active NPI

Pooja Mysore, MD

  • Emergency Medicine Physician
  • Henderson, NV
National Provider Identifier
1629631395
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
27240 Issued in NV
Practice address
1050 W Galleria Dr
Henderson, NV 89011-4800
Phone
(702) 963-7000
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 100905 GA
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 100905 GA
Emergency Medicine Physician 207P00000X 27240 NV Primary

Addresses

Primary practice location

1050 W Galleria Dr
Henderson, NV 89011-4800

Mailing address

4471 Dean Martin Dr Unit 3909
Las Vegas, NV 89103-4116
Phone (631) 833-8616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220916001145 FL Practitioner - Emergency Medicine 8729317425 Reassigns benefits to 1 organization
I20241107003399 GA Practitioner - General Surgery 8729317425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27240NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Emergency Medicine CurrentSince Aug 28, 2024 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Aug 28, 2024 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Sep 2, 2022 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Sep 2, 2022 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Bldg 3
Atlanta, GA 30303

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: pmysore596041@direct.shands.ufl.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1629631395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4471 DEAN MARTIN DR UNIT 3909",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034116",
            "telephone_number": "631-833-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W GALLERIA DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114800",
            "telephone_number": "702-963-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSORE",
        "first_name": "POOJA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "GA",
            "license": "100905",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "GA",
            "license": "100905",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "27240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.