Active NPI
Eric Pollak
- Psychologist
- Douglaston, NY
National Provider Identifier
1720362833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 24302 Northern Blvd
Douglaston, NY 11362-1150 - Phone
- (718) 423-6200
- NPI assigned
- Oct 7, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
24302 Northern Blvd
Douglaston, NY 11362-1150
Mailing address
15040 Jewel Ave
Apt 66a
Flushing, NY 11367-1434
Phone (718) 440-7232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240422001537 | NY | Order and Referring Only - Clinical Psychologist | 3274972385 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- eric.pollak.p1@direct.ezramedical.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317945600000",
"number": "1720362833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15040 JEWEL AVE",
"address_2": "APT 66A",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113671434",
"telephone_number": "718-440-7232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24302 NORTHERN BLVD",
"city": "DOUGLASTON",
"state": "NY",
"postal_code": "113621150",
"telephone_number": "718-423-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLAK",
"first_name": "ERIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-07",
"last_updated": "2011-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglaston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.