Individual provider Active NPI

Marla P Polger, MD

  • Diagnostic Radiology Physician
  • Newton, MA
National Provider Identifier
1083692875
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
74462 Issued in MA
Practice address
2014 Washington St
Newton Wellesley Radiology Associates
Newton, MA 02462
Phone
(617) 243-6600
NPI assigned
Jan 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 74462 MA
Diagnostic Radiology Physician 2085R0202X 74462 MA Primary

Addresses

Primary practice location

2014 Washington St
Newton Wellesley Radiology Associates
Newton, MA 02462

Mailing address

PO Box 417400
Newton Wellesley Radiology Associates
Boston, MA 02241-0001
Phone (800) 360-4391

Other identifiers 1

IdentifierTypeStateIssuer
3092984MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050425000307 MA Practitioner - Diagnostic Radiology 0042258568 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74462MAMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Medical Associates, Inc. Diagnostic Radiology CurrentSince Jul 23, 2020 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Jul 23, 2020 Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jan 1, 2020 Accepting new patients
Brigham & Womens Physicians Organization Inc Body Imaging CurrentSince May 3, 2020 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Jan 1, 2020 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

111 Cypress St
Brookline, MA 02445
Phone (617) 582-1200

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

541 Main St
Ste 210
Weymouth, MA 02190
Phone (781) 952-1200

Organizations & group practices 5

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1083692875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417400",
            "address_2": "NEWTON WELLESLEY RADIOLOGY ASSOCIATES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022410001",
            "telephone_number": "800-360-4391",
            "fax_number": "770-776-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "address_2": "NEWTON WELLESLEY RADIOLOGY ASSOCIATES",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02462",
            "telephone_number": "617-243-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLGER",
        "first_name": "MARLA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MA",
            "license": "74462",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "74462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3092984",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.