Mitra Poorak, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

88999 Issued in SC

Practice address

160 Academy Ave
Greenwood, SC 29646-3808

Phone

(864) 725-4111

NPI assigned

May 9, 2015

Last updated

Aug 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, SC2 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

Specialty

General Surgery

Education

Medical College of Georgia School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071

Merit-based Incentive Payment System (MIPS)

Final score

88.96 of 100Reported as apm

Quality

69.5

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpoorak539609@selfregional.direct-ci.net

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.

• Self Medical Group

  • Surgery Physician
  • Greenwood, SC
  • NPI 1982836847
  Medicare reassignment Care Compare group NPD
• Self Medical Group

  • Surgery Physician
  • Greenwood, SC
  • NPI 1457685570
  NPD
• Self Medical Group

  • Diagnostic Radiology Physician
  • Greenwood, SC
  • NPI 1659839694
  NPD
• Self Medical Group

  dba Advanced Gastroenterology

  • Gastroenterology Physician
  • Greenwood, SC
  • NPI 1841047560
  NPD (past)
• Self Regional Healthcare

  dba Self Medical Center Newberry

  • Family Medicine Physician
  • Newberry, SC
  • NPI 1548068398
  NPD (past)

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

• Self Regional Healthcare

  dba Pain Management Greenwood

  • Pain Medicine (Anesthesiology) Physician
  • Greenwood, SC
  • NPI 1013867498

  Hospital

  Care Compare affiliation
• Self Regional Healthcare

  dba SRH - Inpatient Services

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1023046612
  Care Compare affiliation
• Self Regional Healthcare

  dba SRH - Outpatient Services

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1407887003
  Care Compare affiliation
• Self Regional Healthcare

  dba Pain Management Laurens

  • Pain Medicine (Anesthesiology) Physician
  • Clinton, SC
  • NPI 1720938103

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1431129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1881072940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 VALLEY VIEW RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303384825",
            "telephone_number": "404-516-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463808",
            "telephone_number": "864-725-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120004",
            "country_code": "US",
            "telephone_number": "706-721-7005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 Sigman Rd NE Ste 180",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300123924",
            "country_code": "US",
            "telephone_number": "770-922-4024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POORAK",
        "first_name": "MITRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-09",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "008421",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-161760",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "88999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francisco A Polanco Zacarias, MD
• Viarda Licelot Polanco Zacarias, M.D
• Emily Polatty, RN
• Jowanda Alish Polly, B.S.
• Poole Family Eye Care of Greenwood LLC
• Jessica Powell Pope, NP
• Jessica Porter
• Michelle Caitlin Potts, PHARMD
• Danita Lynn Powell
• Douglas F Powell, MD

• Surgery Physician in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.