Kevin L Polglaze, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

52673-021 Issued in WI

Practice address

855 N Westhaven Dr
Oshkosh, WI 54904-7668

Phone

(920) 456-7400

Fax

(920) 456-7421

NPI assigned

Apr 30, 2009

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Emergency Medicine

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baycare Aurora LLCGroup PAC ID 0244130557, 197 clinicians

Baycare Clinic LLPGroup PAC ID 4385554328, 197 clinicians

Aurora Health Care North IncGroup PAC ID 9436067402, 19 clinicians

Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora Medical Ctr Manitowoc County Hospital, Two Rivers, WI, CCN 520034
• Aurora Baycare Medical Ctr Hospital, Green Bay, WI, CCN 520193
• Aurora Medical Ctr Oshkosh Hospital, Oshkosh, WI, CCN 520198

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpolglaze261469@direct.myadvocateaurora.org

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.

• Aurora Health Care North, Inc.

  • General Acute Care Hospital
  • Two Rivers, WI
  • NPI 1477508687
  Medicare reassignment Care Compare group NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment Care Compare group NPD
• Baycare Aurora, LLC

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1255387726
  Medicare reassignment Care Compare group NPD
• Baycare Clinic LLP

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1588609648
  Medicare reassignment Care Compare group NPD
• Aurora Medical Center of Oshkosh, Inc

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1275578064

  Emergency Medicine

  Medicare reassignment NPD
• Ihc Beaver Dam Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Beaver Dam, WI
  • NPI 1912109836
  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Baycare Clinic LLP

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1134490758
  NPD
• Ihc-Swedishamerican Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Rockford, IL
  • NPI 1093763302
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aurora Health Care North, Inc.

  • General Acute Care Hospital
  • Two Rivers, WI
  • NPI 1477508687
  Care Compare affiliation
• Aurora Medical Center of Oshkosh, Inc

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1275578064
  Care Compare affiliation
• Baycare Aurora, LLC

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1255387726
  Care Compare affiliation

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1053555367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047668",
            "telephone_number": "920-456-7400",
            "fax_number": "920-456-7421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2845 Greenbrier Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116519",
            "country_code": "US",
            "telephone_number": "920-490-9046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLGLAZE",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-30",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "52673-021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpolglaze261469@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomas J Plank, MD
• Planned Parenthood of Wisconsin
• Yasmine Plascencia, FNP-C
• Kevin J Plzak, RPH
• Shannon Polakowski, RN
• Maxie D Pollard, CRNA
• Julianne Katherine Pollei
• Amanda Pomeroy, MCN, RD, CD
• Jennifer Michelle Ponfil
• Danielle J Pontius, MSW

• Emergency Medicine Physician in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.