Kathleen Polak, PT

Primary specialty

SpecialistTaxonomy code 174400000X

License

037194 Issued in NY

Practice address

635 Belle Terre Rd
Ste 204
Port Jefferson, NY 11777-1977

Phone

(631) 474-0008

Fax

(631) 474-0224

NPI assigned

May 21, 2014

Sex

Female

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 NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports Physical Therapy Occupational Therapy and Rehabilitation ServicGroup PAC ID 0446140446, 529 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

77.16 of 100Reported as group

Quality

70

Improvement activities

40

Cost

78.87

Medicare enrollment (NPD)

Enrolled

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.

• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Hand Physical Therapist
  • East Meadow, NY
  • NPI 1770540593
  Medicare reassignment Care Compare group NPD
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Occupational Therapist
  • White Plains, NY
  • NPI 1629825591
  NPD

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1013329333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 BELLE TERRE RD",
            "address_2": "STE 204",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771977",
            "telephone_number": "631-474-0008",
            "fax_number": "631-474-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BELLE TERRE RD",
            "address_2": "STE 204",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771977",
            "telephone_number": "631-474-0008",
            "fax_number": "631-474-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAK",
        "first_name": "KATHLEEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2023-06-09",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "037194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Pironi
• Alannamarie Pisani, OT
• Francis Pizzarelli, LCSW,ACSW, DCSW
• Guillermo Alejandro Plascencia, MD
• Christine Ann Podbielak, LMSW
• Robert David Polin, LCSW
• Port Emergency Medical Services, P.C.
• Port Interventional Radiology PC
• Port Jefferson Allergy & Asthma P.C
• Port Jefferson Dental Group P. C.

• Specialist in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.