NPIMap

Individual provider Active NPI

Rimma Polevoy, MD

  • Internal Medicine Physician
  • Berkley, MI
National Provider Identifier
1134547862
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301105454 Issued in MI
Practice address
1949 12 Mile Rd Ste 100
Berkley, MI 48072
Phone
(248) 551-0615
Fax
(248) 551-7268
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301105454 MI Primary

Addresses

Primary practice location

1949 12 Mile Rd Ste 100
Berkley, MI 48072

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpolevoy70200@direct.beaumont.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170707000525 MI Practitioner - Internal Medicine 6305061367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

1949 W 12 Mile Rd
100 Corewell Health William Beaumont Un
Berkley, MI 48072-1868
Phone (248) 551-0615

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

3535 W 13 Mile Rd
Royal Oak, MI 48073-6770
Phone (248) 551-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Pathology Current Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Jun 30, 2018 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Internal Medicine CurrentSince May 30, 2017 Accepting new patients
Oakwood Ambulatory LLC Internal Medicine CurrentSince Jun 30, 2018 Accepting new patients
Henry Ford Health System CurrentSince May 30, 2017 Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

1949 W 12 Mile Rd
Ste 100
Berkley, MI 48072
Phone (248) 551-0615

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3535 W 13 Mile Rd
Ste Ll
Royal Oak, MI 48073
Phone (248) 551-3000

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: rpolevoy282307@direct.hfhs.org

Organizations & group practices 6

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1134547862",
    "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": "1949 12 MILE RD STE 100",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "48072",
            "telephone_number": "248-551-0615",
            "fax_number": "248-551-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEVOY",
        "first_name": "RIMMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301105454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpolevoy70200@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "1949 12 Mile Rd Ste 100",
            "city": "Berkley",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.