Active NPI
Evelyn Carolina Polanco
- Anatomic Pathology & Clinical Pathology Physician
- Royal Oak, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 4301504844
- Practice address
- 3601 W 13 Mile Rd
Royal Oak, MI 48073-6712 - Phone
- (248) 898-9060
- NPI assigned
- Jul 7, 2012
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 4301504844 | MI | Primary |
Addresses
Primary practice location
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Other practice location 1
10000 Telegraph Rd
Taylor, MI 48180-3330
Phone (313) 295-5360
Other practice location 2
468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1615
Other practice location 3
5450 Fort St
Trenton, MI 48183-4601
Phone (734) 671-3866
Other practice location 4
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-4130
Other practice location 5
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7965
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | epolancojacome2756239@direct.beaumont.edu | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- 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
- Pathology
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
18101 Oakwood Blvd
Dearborn, MI 48124-4089
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (947) 521-8196
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-0575
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187
44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111
468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1605
Hospital & facility affiliations
- Beaumont Hospital Royal Oak
- Beaumont Hospital - Grosse Pointe
- Beaumont Hospital - Dearborn
- Beaumont Hospital - Farmington Hills
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.64 of 100
- Quality
- 85.06
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301504844 | MI | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaumont Medical Group Hospital -Based Services | Current | Accepting new patients |
Locations
18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780
468 Cadieux Rd
Grosse Pt Wds, MI 48230
Phone (313) 343-1000
3601 W 13 Mile Rd
Royal Oak, MI 48073
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
5450 Fort St
Woodhaven, MI 48183
Phone (734) 671-3297
Interoperability endpoints
- epolancojacome1251288@epic00.shdirect.org
- epolancojacome2756239@direct.beaumont.edu
Organizations & group practices 1
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.
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1427567858
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- General Acute Care Hospital
- Dearborn, MI
- NPI 1740230119
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692230400000",
"number": "1083979975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 W 13 MILE RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736712",
"telephone_number": "248-898-9060"
}
],
"practiceLocations": [
{
"address_1": "10000 Telegraph Rd",
"address_purpose": "LOCATION",
"city": "Taylor",
"state": "MI",
"postal_code": "481803330",
"country_code": "US",
"telephone_number": "313-295-5360",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "468 Cadieux Rd",
"address_purpose": "LOCATION",
"city": "Grosse Pointe",
"state": "MI",
"postal_code": "482301507",
"country_code": "US",
"telephone_number": "313-473-1615",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5450 Fort St",
"address_purpose": "LOCATION",
"city": "Trenton",
"state": "MI",
"postal_code": "481834601",
"country_code": "US",
"telephone_number": "734-671-3866",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "44201 Dequindre Rd",
"address_purpose": "LOCATION",
"city": "Troy",
"state": "MI",
"postal_code": "480851117",
"country_code": "US",
"telephone_number": "248-964-4130",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "18101 Oakwood Blvd",
"address_purpose": "LOCATION",
"city": "Dearborn",
"state": "MI",
"postal_code": "481244089",
"country_code": "US",
"telephone_number": "313-593-7965",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLANCO",
"first_name": "EVELYN",
"middle_name": "CAROLINA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-07",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MI",
"license": "4301504844",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "epolancojacome2756239@direct.beaumont.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3601 W 13 Mile Rd",
"city": "Royal Oak",
"state": "MI",
"country_code": "US",
"postal_code": "480736712",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.