NPIMap

Individual provider Active NPI

Michael N Polinsky, M.D.

  • Neurological Surgery Physician
  • Saint Peters, MO
National Provider Identifier
1134183205
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
112503 Issued in MO
Practice address
5301 Veterans Memorial Pkwy Ste 105
Saint Peters, MO 63376-3429
Phone
(888) 828-8608
Fax
(314) 558-9017
NPI assigned
Apr 14, 2006
Last updated
May 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036159037 IL
Neurological Surgery Physician 207T00000X 112503 MO Primary

Addresses

Primary practice location

5301 Veterans Memorial Pkwy Ste 105
Saint Peters, MO 63376-3429

Mailing address

5301 Veterans Memorial Pkwy Ste 105
Saint Peters, MO 63376-3429
Phone (888) 828-8608

Other practice location 1

112 Piper Hill Dr Ste 12
Saint Peters, MO 63376-1690
Phone (888) 828-8608

Other practice location 2

3 Saint Elizabeth Blvd Ste 3900
O Fallon, IL 62269-1282
Phone (888) 828-8608

Other identifiers 1

IdentifierTypeStateIssuer
208722207MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE) Missouri Baptist Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050815000784 MO Practitioner - NeurosurgeryPractitioner - Orthopedic Surgery 7810927324 Reassigns benefits to 2 organizations
I20220209001629 IL Practitioner - Neurosurgery 7810927324 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology of St Louis IncGroup PAC ID 6204723786, 112 clinicians

Practice addresses (Care Compare)

112 Piper Hill Dr
Suite 12
Saint Peters, MO 63376-1690
Phone (636) 939-9202

12855 N 40 Dr
Suite 375
Saint Louis, MO 63141-8657

9594 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 274-6314

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.16 of 100Reported as group
Quality
55.68
Promoting interoperability
100
Improvement activities
40
Cost
74.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion131
Laminectomy or laminotomy (partial removal of spine bones)85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112503MOMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of St. Louis, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Urology of St. Louis, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Anderson Medical Group, LLC Neurological Surgery CurrentSince May 1, 2022 Accepting new patients
Digestive Consultants LLC PastSince Jan 9, 2023 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Urology of St. Louis, Inc. Past Accepting new patients
Atc, LLC Past Accepting new patients

Locations

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

6812 State Route 162
Ste 200
Maryville, IL 62062
Phone (618) 288-0900

6828 State Route 162
Ste A
Maryville, IL 62062
Phone (618) 288-8363

3 Saint Elizabeth Blvd
Ste 3900
O Fallon, IL 62269
Phone (314) 806-1770

12855 N 40 Dr
Saint Louis, MO 63141
Phone (314) 432-4415

12855 N 40 Dr
Ste 125
Saint Louis, MO 63141
Phone (314) 806-1770

12855 N 40 Dr
Ste 375
Saint Louis, MO 63141

3009 N Ballas Rd
Ste 250C
Saint Louis, MO 63131
Phone (314) 432-5616

112 Piper Hill Dr
Ste 12
Saint Peters, MO 63376
Phone (314) 806-1770

5301 Veterans Memorial Pkwy
Ste 105
Saint Peters, MO 63376
Phone (314) 806-1770

Interoperability endpoints

  • Direct secure messaging: michaelpolinsky@slus.allscriptsdirect.net
  • Direct secure messaging: mpolinsky244468@direct.carenet.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1134183205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 VETERANS MEMORIAL PKWY STE 105",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633763429",
            "telephone_number": "888-828-8608",
            "fax_number": "314-558-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 VETERANS MEMORIAL PKWY STE 105",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633763429",
            "telephone_number": "888-828-8608",
            "fax_number": "314-558-9017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Piper Hill Dr Ste 12",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761690",
            "country_code": "US",
            "telephone_number": "888-828-8608",
            "fax_number": "314-558-9017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Saint Elizabeth Blvd Ste 3900",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691282",
            "country_code": "US",
            "telephone_number": "888-828-8608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLINSKY",
        "first_name": "MICHAEL",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036159037",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "112503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208722207",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Missouri Baptist Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.