Individual provider Active NPI

Nina M Poliak, M.D.

  • Pediatrics Physician
  • Wilkes Barre, PA
National Provider Identifier
1033445614
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD435420 Issued in PA
Practice address
169 N Pennsylvania Ave
Wilkes Barre, PA 18701-3603
Phone
(570) 491-0126
Fax
(570) 230-0013
NPI assigned
Nov 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MT194363 PA
Pediatrics Physician 208000000X MD435420 PA Primary

Addresses

Primary practice location

169 N Pennsylvania Ave
Wilkes Barre, PA 18701-3603

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150202001090 PA Practitioner - Pediatric Medicine 3173848785 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT194363PAMDAllergy & Immunology Physician
MD435420PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HR Physician Services Current Accepting new patients
HR Physician Services CurrentSince Nov 13, 2021 Accepting new patients
HR Physician Services Pediatrics CurrentSince Nov 13, 2021 Accepting new patients

Locations

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

1650 Huntingdon Pike
Ste 160
Meadowbrook, PA 19046
Phone (215) 344-9560

1648 Huntingdon Pike
Fl 1
Meadowbrook, PA 19046
Phone (215) 938-2040

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1033445614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 N PENNSYLVANIA AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187013603",
            "telephone_number": "570-491-0126",
            "fax_number": "570-230-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIAK",
        "first_name": "NINA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "MT194363",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD435420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.