Douglas Pollack, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

038336 Issued in NY

Practice address

462 1St Ave
# 3149
New York, NY 10016-9196

Phone

(212) 562-5526

NPI assigned

Nov 30, 2006

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

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: dpollack681107@nychhc.direct-ci.com

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.

• New York City Health and Hospitals Corporation

  dba Jacobi Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972671063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 TUDOR CITY PL",
            "address_2": "# 1739",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176853",
            "telephone_number": "917-991-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "address_2": "# 3149",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "038336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "038336",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Ellen Pollack, MD, MPH
• Aryeh L. Pollack, MD
• Bruce Matthew Pollack, LCSW
• Carrie Pollack
• Darren Keith Pollack, DC
• Geoffrey J Pollack, MD
• Harris Isaac Pollack, LMSW
• Henry J. Pollack, M.D.
• Ian M Pollack
• Jessica Pollack

• Pediatric Dentistry in New York, NY
• Providers in New York, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.