Individual provider Active NPI

Polina Gaisinskaya, MD

  • Gastroenterology Physician
  • Vineland, NJ
National Provider Identifier
1164050076
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA11845000 Issued in NJ
Practice address
1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone
(856) 641-8000
NPI assigned
Mar 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X EMC0009755 MI
Gastroenterology Physician 207RG0100X 25MA11845000 NJ Primary

Addresses

Primary practice location

1505 W Sherman Ave
Vineland, NJ 08360-7059

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other practice location 1

3304 Cooley Ct
Portage, MI 49024-7430
Phone (269) 349-2266

Other practice location 2

800 Meadows Rd
Boca Raton, FL 33486-2304
Phone (561) 955-5365

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200515000043 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8921439522

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164050076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607059",
            "telephone_number": "856-641-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3304 Cooley Ct",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490247430",
            "country_code": "US",
            "telephone_number": "269-349-2266",
            "fax_number": "269-349-0792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Meadows Rd",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334862304",
            "country_code": "US",
            "telephone_number": "561-955-5365",
            "fax_number": "561-955-3577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAISINSKAYA",
        "first_name": "POLINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "EMC0009755",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA11845000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.