Individual provider Active NPI

Michele Polon

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1184615049
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS010615L Issued in PA
Practice address
1339 W 6TH St
Erie, PA 16505-2503
Phone
(814) 877-8170
NPI assigned
Oct 31, 2005
Last updated
Mar 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS010615L PA Primary

Addresses

Primary practice location

1339 W 6TH St
Erie, PA 16505-2503

Mailing address

1339 W 6TH St
Erie, PA 16505-2503

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michele.polon@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050504000903 PA Practitioner - Family Practice 7719927268 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS010615LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc Family Medicine CurrentSince Jan 1, 2010 Accepting new patients
Epn Hamot Urgent Care LLC Family Medicine CurrentSince Apr 30, 2021 Accepting new patients
Regional Health Services, Inc. PastSince Dec 1, 2019 Accepting new patients

Locations

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

7200 Peach St
Unit 16
Erie, PA 16509
Phone (814) 860-3301

510 Cranberry St
Ste 200
Erie, PA 16507
Phone (814) 459-3141

1339 W 6th St
Erie, PA 16505
Phone (814) 480-8170

2861 W 26th St
Erie, PA 16506
Phone (814) 480-7760

2 Hot Metal St
Bldg 3RD
Pittsburgh, PA 15203

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1184615049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 W 6TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 W 6TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052503",
            "telephone_number": "814-877-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLON",
        "first_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2021-03-25",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS010615L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michele.polon@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.