Stella Polvanova, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F305534-1 Issued in NY

Practice address

529 Beach 20TH St
Far Rockaway, NY 11691-3645

Phone

(718) 327-7307

Fax

(718) 327-3294

NPI assigned

Jun 1, 2011

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Multiviz Medical Services PC

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1720373293
  Medicare reassignment NPD
• Provider Partners Care Management LP

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1013348028

  NY

  Medicare reassignment NPD
• Abiola Olawale Familusi, MD

  • Internal Medicine Physician
  • Blanchester, OH
  • NPI 1649351214

  NY

  Medicare reassignment

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1013201557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913645",
            "telephone_number": "718-327-7307",
            "fax_number": "718-327-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913645",
            "telephone_number": "718-327-7307",
            "fax_number": "718-327-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLVANOVA",
        "first_name": "STELLA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "486629-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305534-1",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340789-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doris Polaniecki, LMSW
• Serena Polatoff, LMSW
• Chana Polishuk
• Alizah Politzer, SLP M.S
• Francesco Paolo Polizzi, DO
• Laura Amy Pomerantz
• Sally R. Ponceley, R.N.
• Posh Senior Ride
• Post Injury Medical Treatment PC
• Ashley Amadis Powell, LMSW

• Adult Health Nurse Practitioner in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.