Active NPI
Laura E. Polan, MD
- Emergency Medicine Physician
- Worcester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 243309
- Practice address
- 123 Summer St
Saint Vincent Hospital, Emergency Department
Worcester, MA 01608-1216 - Phone
- (508) 363-6090
- NPI assigned
- Apr 30, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 243309 | MA | Primary |
Addresses
Primary practice location
123 Summer St
Saint Vincent Hospital, Emergency Department
Worcester, MA 01608-1216
Mailing address
123 Summer St
Saint Vincent Hospital, Emergency Department
Worcester, MA 01608-1216
Phone (508) 363-6090
Other practice location 1
201 Highland St
Clinton, MA 01510-1037
Phone (508) 421-1400
Other practice location 2
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 421-1400
Other practice location 3
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 421-1400
Other practice location 4
157 Union St
Marlborough, MA 01752-1228
Phone (508) 421-1400
Other practice location 5
510 N Main St
Leominster, MA 01453-1814
Phone (508) 421-1400
Other practice location 6
60 Hospital Rd
Leominster, MA 01453-2205
Phone (508) 421-1400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110085362A | Medicaid | MA |
Other names 1
- Laura Elizabether Bothwell
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lpolan332383@UmassMemorial.direct-ci.com | ||
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Massachusetts Medical School, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000
Hospital & facility affiliations
- Umass Memorial Medical Center/University Campus
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 82.98
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group Inc | Emergency Medicine | Current | Accepting new patients |
| Umass Memorial Medical Group, Inc. | Current | Accepting new patients |
Locations
201 Highland St
Clinton, MA 01510
Phone (508) 421-1400
510 N Main St
Leominster, MA 01453
Phone (508) 421-1400
60 Hospital Rd
Leominster, MA 01453
Phone (978) 466-2000
157 Union St
Marlborough, MA 01752
Phone (508) 481-5000
123 Summer St
Worcester, MA 01608
Phone (508) 363-6000
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345
Interoperability endpoints
- lpolan332383@umassmemorial.direct-ci.com
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
Emergency Medicine
-
- Urgent Care Clinic/Center
- Oxford, MA
- NPI 1982381018
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Worcester, MA
- NPI 1831151455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1083880033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 SUMMER ST",
"address_2": "SAINT VINCENT HOSPITAL, EMERGENCY DEPARTMENT",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081216",
"telephone_number": "508-363-6090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 SUMMER ST",
"address_2": "SAINT VINCENT HOSPITAL, EMERGENCY DEPARTMENT",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081216",
"telephone_number": "508-363-6090"
}
],
"practiceLocations": [
{
"address_1": "201 Highland St",
"address_purpose": "LOCATION",
"city": "Clinton",
"state": "MA",
"postal_code": "015101037",
"country_code": "US",
"telephone_number": "508-421-1400",
"fax_number": "508-421-1490",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "119 Belmont St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016052903",
"country_code": "US",
"telephone_number": "508-421-1400",
"fax_number": "508-421-1490",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "55 Lake Ave N",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016550002",
"country_code": "US",
"telephone_number": "508-421-1400",
"fax_number": "508-421-1490",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "157 Union St",
"address_purpose": "LOCATION",
"city": "Marlborough",
"state": "MA",
"postal_code": "017521228",
"country_code": "US",
"telephone_number": "508-421-1400",
"fax_number": "508-421-1490",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "510 N Main St",
"address_purpose": "LOCATION",
"city": "Leominster",
"state": "MA",
"postal_code": "014531814",
"country_code": "US",
"telephone_number": "508-421-1400",
"fax_number": "508-421-1490",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "60 Hospital Rd",
"address_purpose": "LOCATION",
"city": "Leominster",
"state": "MA",
"postal_code": "014532205",
"country_code": "US",
"telephone_number": "508-421-1400",
"fax_number": "508-421-1490",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLAN",
"first_name": "LAURA",
"middle_name": "E.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "243309",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110085362A",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lpolan332383@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LAURA",
"last_name": "BOTHWELL",
"middle_name": "ELIZABETHER",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.