Alyssa Diane Polk, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

76237 Issued in WI

Practice address

191 Theater Rd
Onalaska, WI 54650-8679

Phone

(608) 785-0940

NPI assigned

Apr 2, 2020

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

• Alyssa Diane Kennedy Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reedsburg Area Medical Center IncGroup PAC ID 9830008259, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health at Home Home Health-Wisconsin Home health agency, Madison, WI, CCN 527184
• Aveanna Home Health Home health agency, Baraboo, WI, CCN 527332
• Agrace Hospicecare Hospice, Madison, WI, CCN 521505
• Reedsburg Area Medical Center Hospital, Reedsburg, WI, CCN 521351
• Ridgeview Terrace Long Term Care Nursing home, Reedsburg, WI, CCN 525667

Merit-based Incentive Payment System (MIPS)

Final score

95.62 of 100Reported as group

Quality

94.84

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akennedy617427@ehrdirect.mayoclinicmsg.org
• Direct secure messaging: apolk981179@direct.unitypoint.org

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.

• Reedsburg Area Medical Center, Inc.

  • Critical Access Hospital
  • Reedsburg, WI
  • NPI 1891796710
  Medicare reassignment Care Compare group NPD
• Reedsburg Area Medical Center Inc

  • Rural Health Clinic/Center
  • La Valle, WI
  • NPI 1437049566
  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Agrace Hospicecare, Incorporated

  • Community Based Hospice Care Agency
  • Fitchburg, WI
  • NPI 1861503534
  Care Compare affiliation
• Home Health United Inc

  • Home Health Agency
  • Madison, WI
  • NPI 1275686404
  Care Compare affiliation
• Recover Health of Wisconsin, Inc.

  • Home Health Agency
  • Madison, WI
  • NPI 1568469070
  Care Compare affiliation
• Reedsburg Area Medical Center, Inc.

  • Family Medicine Physician
  • Reedsburg, WI
  • NPI 1457780983

  Hospital

  Care Compare affiliation
• Reedsburg Area Medical Center, Inc.

  • Critical Access Hospital
  • Reedsburg, WI
  • NPI 1891796710
  Care Compare affiliation
• Reedsburg Area Senior Life Center Inc

  • Skilled Nursing Facility
  • Reedsburg, WI
  • NPI 1023006814

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1174152102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 THEATER RD",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508679",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 West Ave S",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546014783",
            "country_code": "US",
            "telephone_number": "815-355-0016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLK",
        "first_name": "ALYSSA",
        "middle_name": "DIANE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "76237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akennedy617427@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "191 Theater Rd",
            "city": "Onalaska",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546508679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "KENNEDY",
            "middle_name": "DIANE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walfsty Pierre, MSW, LCSW
• Amy Pike, CNP
• Nicole Lynn Pleggenkuhle, DC
• Gretchen Poellinger, LPC
• Scott Polito, MT-BC
• Sally Cecile Pollock, FNP
• Ryan Mark Powis
• Faith Pranno, PHARMD
• Ann Prell, NP
• Kelsie Marie Prins, DO

• Family Medicine Physician in Onalaska, WI
• Providers in Onalaska, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.