Kelly Anne Polak, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN063628 Issued in AZ

Practice address

9003 E Shea Blvd
Scottsdale, AZ 85260-6709

Phone

(480) 323-3350

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpolak105000@direct.honorhealth.com

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.

• Honorhealth Ambulatory

  • Hematology & Oncology Physician
  • Scottsdale, AZ
  • NPI 1407050917
  Medicare reassignment Care Compare group NPD
• Honorhealth Ambulatory

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1891518130
  NPD
• Scottsdale Healthcare Corp

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1609150010
  NPD
• Honorhealth Ambulatory

  • Cardiovascular Disease Physician
  • Scottsdale, AZ
  • NPI 1275833915
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1114133162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13601 W PINCHOT AVE",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853923552",
            "telephone_number": "602-980-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9003 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606709",
            "telephone_number": "480-323-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAK",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN063628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Pogue
• Brian Francis Poirier, MD
• Keren Israel Poirier, LCSW
• Utsav Pokharel
• Kelly Pokrywiecki, PA(ASCP)
• Elyse Polanco, FNP-C
• Polaris Management Group LLC
• Michelle Lee Polchow, RN
• Anthony Polechetti, DO
• Polished Holdings Inc

• Family Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.

Verify at the official NPI Registry.