Polly A Retz, RN, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

587900 Issued in TX

Practice address

11714 Wilson Parke Ave Ste 150
Austin, TX 78726-4061

Phone

(512) 346-6611

Fax

(512) 406-6267

NPI assigned

Apr 4, 2007

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

Other identifiers 2

Other names 1

• Polly Anne Retz-Kruczkowski Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pretz9937@arcmd.direct-ci.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.

• Austin Regional Clinic, PA

  dba ARC- Center Street

  • Durable Medical Equipment & Medical Supplies
  • Kyle, TX
  • NPI 1235746413
  NPD
• Austin Regional Clinic, PA

  • Family Medicine Physician
  • Austin, TX
  • NPI 1821157579

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1023130911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290 STE 240",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11714 WILSON PARKE AVE STE 150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787264061",
            "telephone_number": "512-346-6611",
            "fax_number": "512-406-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETZ",
        "first_name": "POLLY",
        "middle_name": "A",
        "credential": "RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "587900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182838605",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182838606",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "POLLY",
            "last_name": "RETZ-KRUCZKOWSKI",
            "middle_name": "ANNE",
            "credential": "CPNP-PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Retirement and Nursing Center, Austin, LTD.
• Retirement Austin Nursing & Rehab LLC
• Susan Retondo
• Retrofit Performance Training LLC (Triarc Health and Wellness)
• Retrospective Solutions
• David William Reue, MD
• Colleen Reuter, MED, LPC ASSOCIATE
• Revealing Hope Counseling PLLC
• Jennifer Revell
• Ashley Revels

• Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.