Mariano A. Polidori, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01064068A Issued in IN

Practice address

303 Poinciana Island Dr
Sunny Isles Beach, FL 33160

Phone

(631) 383-7326

NPI assigned

Oct 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Amago Inpatient Services LLCGroup PAC ID 7214259704, 21 clinicians

St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104
• Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100
• Caldwell Medical Center Hospital, Princeton, KY, CCN 181322
• Jackson Purchase Medical Center Hospital, Mayfield, KY, CCN 180116

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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.

• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Hospitalist, KY

  Medicare reassignment Care Compare group NPD
• St Mary'S Medical Group, LLC

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1164852539

  Family Medicine, IN

  Medicare reassignment Care Compare group NPD
• Amago Inpatient Services LLC

  • Emergency Medicine Physician
  • Paducah, KY
  • NPI 1174925994

  KY

  Medicare reassignment Care Compare group
• St Mary'S Medical Group, LLC

  • Nephrology Physician
  • Evansville, IN
  • NPI 1619307873
  NPD
• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  NPD (past)
• Hospitalist Medicine Physicians of Franklin County, LTD

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1326088782
  NPD (past)
• Hospitalist Medicine Physicians of Kentucky, PLLC

  • Internal Medicine Physician
  • Paducah, KY
  • NPI 1346563236
  NPD (past)
• Western Baptist Medical Ventures, Inc.

  • Neurological Surgery Physician
  • Paducah, KY
  • NPI 1316017080
  NPD (past)

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

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128

  Hospital

  Care Compare affiliation
• Caldwell County Hospital, Inc

  • Occupational Medicine Physician
  • Princeton, KY
  • NPI 1780688333

  Hospital

  Care Compare affiliation
• Pinelake Regional Hospital LLC

  • Rural Acute Care Hospital
  • Mayfield, KY
  • NPI 1891892741

  Hospital

  Care Compare affiliation
• St. Mary'S Health, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1427082957

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1053590752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 POINCIANA ISLAND DR",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331604526",
            "telephone_number": "631-383-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 POINCIANA ISLAND DR",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "33160",
            "telephone_number": "631-383-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIDORI",
        "first_name": "MARIANO",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-30",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "44758",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME111921",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01064068A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100158310",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Theresa Perry, LCSW
• Ksenia Petrushkina, PA
• Platinum Health Ca PC
• Platinum Health PA
• Milena Poleshchuk
• Marcelo Henares Porto, PT
• Mariia Posokhova
• Power South Corp
• Paola Preciado
• Primex Group, Inc.

• All providers in Sunny Isles Beach, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.