Michael Polidoro, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

009063 Issued in NY

Practice address

375 E Main St
Ste 1
Bay Shore, NY 11706-8418

Phone

(631) 665-8790

Fax

(631) 665-1581

NPI assigned

Jul 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 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

Merit-based Incentive Payment System (MIPS)

Final score

86.33 of 100Reported as group

Quality

82.1

Promoting interoperability

100

Improvement activities

40

Cost

72.34

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• City Medical of Upper East Side, PLLC

  dba Summit Health

  • Urgent Care Clinic/Center
  • Bay Shore, NY
  • NPI 1992580070
  NPD (past)
• Orthopaedics Spine and Sports Medicine LLC

  dba Total Orthopaedics and Sports Medicine, LLP

  • Orthopaedic Surgery Physician
  • Syosset, NY
  • NPI 1548490063
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043236375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 E MAIN ST",
            "address_2": "STE 1",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068418",
            "telephone_number": "631-665-8790",
            "fax_number": "631-665-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E MAIN ST",
            "address_2": "STE 1",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068418",
            "telephone_number": "631-665-8790",
            "fax_number": "631-665-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIDORO",
        "first_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claude Pluviose
• Matthew Alexander Poblano, R.N.
• Mindy Theresa Podesta, CCCSLP
• Charles Pohanka IV, MD
• Gina Polidoro-Yodice, LMHC
• Vincent Polo, PA
• Shedely Polynice
• Max Ricardo Pommier Jr., D.O.
• Escarleth Adony Ponce Fuentes
• Eleanor Ponce, L.C.S.W-R

• Physician Assistant in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.