Alex John Polenick, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50.005589RX Issued in OH

Practice address

1499 Boardman Canfield Rd
Boardman, OH 44512-4008

Phone

(330) 758-0577

Fax

(330) 533-4587

NPI assigned

Aug 22, 2018

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

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Youngstown Orthopaedic Associates LTDGroup PAC ID 4587559562, 37 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

70.01 of 100Reported as group

Quality

64.72

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: alex.polenick.1@33257.direct.athenahealth.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.

• Youngstown Orthopaedic Associates LTD

  • Orthopaedic Surgery Physician
  • Youngstown, OH
  • NPI 1932102506
  Medicare reassignment Care Compare group
• Youngstown Orthopaedic Associates LTD

  • Orthopaedic Surgery Physician
  • Warren, OH
  • NPI 1255784187
  NPD (past)
• Youngstown Orthopaedic Associates LTD

  • Orthopaedic Surgery Physician
  • Boardman, OH
  • NPI 1881697225
  NPD (past)

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1003397654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8591 CROSSROADS DRIVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44514",
            "telephone_number": "330-758-0577",
            "fax_number": "330-758-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124008",
            "telephone_number": "330-758-0577",
            "fax_number": "330-533-4587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 Niles Cortland Rd NE",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444841165",
            "country_code": "US",
            "telephone_number": "330-758-0577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLENICK",
        "first_name": "ALEX",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-22",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.005589RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pinnacle Health Concepts, LLC
• Pinnacle Integrated Health, LLC
• Sara Plate, SLP
• Anna Plummer
• Mark D Plunkett, CRNA
• Kathryn Polito, RD
• Heather K Poma, PSYD
• Pompeo Chiropractic
• Michael Joseph Pompeo, DC
• Maria R Ponzi, MSW, LISW-S

• Medical Physician Assistant in Boardman, OH
• Providers in Boardman, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.