ANGELA POBLOCKI – Physician Assistant, NPI 1982133294
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,244 PHYSICIAN ASSISTANT in NY
Provider Addresses for ANGELA POBLOCKI
5723 N AUTUMN RIDGE CT APT C
PEORIA, IL 616153078
Phone:
Type: Mailing
1419 Salt Springs Rd
Syracuse, NY 132141302
Phone: (315) 445-4100
Type: Location
1506 W GARFIELD AVE
BARTONVILLE, IL 616071755
Phone: (309) 697-2416
Type: Location
13583 STEINER RD
AKRON, NY 140019591
Phone:
Type: Mailing
Le Moyne College, 1419, Salt Springs Road, Salt Springs, Dewitt, Onondaga County, New York, 13214, United States
SYRACUSE, NY 132141302
Phone: (315) 445-4100
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-03-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240307001138 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61615)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | IL | |
| Nurse Practitioner | IL | |
| Clinical Psychologist | IL | |
| - | FL | |
| Nurse Practitioner | IL | |
| Gastroenterology, Internal Medicine | WI | |
| P O D I A T R Y | IL | |
| Hospitalist, Family Practice | TX | |
| Diagnostic Radiology | NY | |
| - | IL |
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