Active NPI
Jose Poliak, M.D.,P.A.
- Ophthalmology Physician
- Margate, FL
National Provider Identifier
1063407211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME0053075
- Practice address
- 5800 Colonial Dr
Suite 306
Margate, FL 33063-5682 - Phone
- (954) 979-8770
- Fax
- (954) 969-9097
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | ME0053075 | FL | Primary |
Addresses
Primary practice location
5800 Colonial Dr
Suite 306
Margate, FL 33063-5682
Mailing address
5800 Colonial Dr
Suite 306
Margate, FL 33063-5682
Phone (954) 979-8770
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HUMANA | Other | FL | 550835620 |
| 048914000 | Medicaid | FL | |
| AETNA | Other | FL | 4072990 |
| CIGNA | Other | FL | 550835620 |
| UNITED HEALTHCARE | Other | FL | 550835620 |
| BLUECROSS BLUESHIEL | Other | FL | 07358 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0053075 | FL | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341792000000",
"number": "1063407211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5800 COLONIAL DR",
"address_2": "SUITE 306",
"city": "MARGATE",
"state": "FL",
"postal_code": "330635682",
"telephone_number": "954-979-8770",
"fax_number": "954-969-9097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5800 COLONIAL DR",
"address_2": "SUITE 306",
"city": "MARGATE",
"state": "FL",
"postal_code": "330635682",
"telephone_number": "954-979-8770",
"fax_number": "954-969-9097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLIAK",
"first_name": "JOSE",
"name_prefix": "Dr.",
"credential": "M.D.,P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2012-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME0053075",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "550835620",
"identifier": "HUMANA",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "048914000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "4072990",
"identifier": "AETNA",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "550835620",
"identifier": "CIGNA",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "550835620",
"identifier": "UNITED HEALTHCARE",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "07358",
"identifier": "BLUECROSS BLUESHIEL",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Margate, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.