Individual provider Active NPI

Danielle Nicole Polansky, PA-C

  • Physician Assistant
  • Minersville, PA
National Provider Identifier
1104434943
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
232 Sunbury St
Minersville, PA 17954-1346
Phone
(570) 544-4590
NPI assigned
Jul 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA Primary

Addresses

Primary practice location

232 Sunbury St
Minersville, PA 17954-1346

Mailing address

1057 Chestnut St
Pottsville, PA 17901-9002
Phone (570) 617-4407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812001164 PA Practitioner - Physician Assistant 8123444825 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

420 S Jackson St
Pottsville, PA 17901-3625
Phone (570) 621-5000

48 Tunnel Rd
Pottsville, PA 17901-3875

700 Schuylkill Manor Rd
Pottsville, PA 17901-3849

Hospital & facility affiliations

  • Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030
  • Geisinger St. Luke'S Hospital Hospital, Orwigsburg, PA, CCN 390332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group, P.C. CurrentSince Aug 24, 2020 Accepting new patients
Integrated Medical Group Past Accepting new patients

Locations

232 Sunbury St
Minersville, PA 17954
Phone (570) 544-4590

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

700 Schuylkill Manor Rd
Ste 5A
Pottsville, PA 17901
Phone (570) 516-9444

401 University Dr
Schuylkill Haven, PA 17972
Phone (570) 385-0331

Interoperability endpoints

  • Direct secure messaging: dpolansky@imgpc.medentdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1104434943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 CHESTNUT ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179019002",
            "telephone_number": "570-617-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 SUNBURY ST",
            "city": "MINERSVILLE",
            "state": "PA",
            "postal_code": "179541346",
            "telephone_number": "570-544-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANSKY",
        "first_name": "DANIELLE",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minersville, PA

Sources for this page

Verify at the official NPI Registry.