Polina Radchenkova, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9110510 Issued in FL

Practice address

1110 Brickell Ave Ste 400-K56
Miami, FL 33131-3132

Phone

(601) 669-6698

NPI assigned

Nov 22, 2017

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

Other names 1

• Polina Dasgupta Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Ep Facility LLC

  • Psychiatry Physician
  • Miami, FL
  • NPI 1275399933
  NPD (past)
• Gia Boca Raton, LLC

  • Psychiatry Physician
  • Boca Raton, FL
  • NPI 1740961648
  NPD (past)
• Vitalmd Group Holding LLC

  • Obstetrics & Gynecology Physician
  • Miami, FL
  • NPI 1871572032
  NPD (past)

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1174037477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 BRICKELL AVE STE 400-K56",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331313132",
            "telephone_number": "601-669-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BRICKELL AVE STE 400-K56",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331313132",
            "telephone_number": "601-669-6698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Biscayne Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331321461",
            "country_code": "US",
            "telephone_number": "786-733-0700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADCHENKOVA",
        "first_name": "POLINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "POLINA",
            "last_name": "DASGUPTA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachell Home Health Services, Corp
• David A Racher, MD
• Jake Rachiele, MD
• Allison Justine Rad, APRN
• Gregory Jose Rada Longa
• Iryna Radchykava
• Erica Radcliffe-Henry, PA-C
• Ottmar Raddatz Martinez
• Raegan Marie Radenheimer, PSYD
• Surya Radhakrishnan

• Medical Physician Assistant in Miami, FL
• Providers in Miami, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.