THOMAS POLLACK PH.D.
NPI 1316949647
Psychologist in Frederick, MD

Active since May 31, 2005Opted out of Medicare · through Oct 1, 2027
170 THOMAS JOHNSON DR, STE 200, FREDERICK, MD 21702(301) 695-8390(301) 694-7906 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Thomas Pollack Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THOMAS POLLACK PH.D. (NPI 1316949647) is an individual psychologist in Frederick, Maryland, licensed in Maryland (2750) and active in the NPI registry since May 2005. He has opted out of Medicare through October 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1316949647
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameTHOMAS POLLACKCredential: PH.D.
Location Address170 THOMAS JOHNSON DR, STE 200Frederick, MD 21702-6200
Mailing Address170 Thomas Johnson DrFrederick, MD 21702-4354 · (301) 695-8390 · Fax (301) 694-7906
Fax(301) 694-7906
Enumeration DateMay 31, 2005
Last NPPES UpdateJuly 8, 2007
NPI 1316949647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MD · 2750
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

170 THOMAS JOHNSON DR, Frederick, MD 21702

Other Identifiers 2

Other339104MD · Mamsi
Medicare ID-Type Unspecified921CMD

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Thomas Pollack Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2015 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2015
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Physical Therapy)
170 THOMAS JOHNSON DR, SUITE 104
FREDERICK, MD 21702
Physical Therapist
170 THOMAS JOHNSON DR
FREDERICK, MD 21702
Social Worker (Clinical)
170 THOMAS JOHNSON DR, STE 200
FREDERICK, MD 21702
Social Worker (Clinical)
170 THOMAS JOHNSON DR, SUITE 200
FREDERICK, MD 21702
Physical Therapist
170 THOMAS JOHNSON DR, STE. 102
FREDERICK, MD 21702
Counselor (Mental Health)
170 THOMAS JOHNSON DR, STE 200
FREDERICK, MD 21702
Psychiatry & Neurology (Psychiatry)
170 THOMAS JOHNSON DR, STE 200
FREDERICK, MD 21702
Psychiatry & Neurology (Psychiatry)
170 THOMAS JOHNSON DR, SUITE 200
FREDERICK, MD 21702

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316949647, enumerated as an "individual" on May 31, 2005.

The provider is located at 170 THOMAS JOHNSON DR STE 200 FREDERICK, MD 21702 and the phone number is (301) 695-8390.

Psychologist with taxonomy code 103T00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.