Active NPI
Susan Marie Polka, P.T.
- Physical Therapist
- Plymouth Meeting, PA
National Provider Identifier
1184841702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT007535L
- Practice address
- 2250 Hickory Rd Ste 240
Plymouth Meeting, PA 19462-2225 - Phone
- (800) 355-1225
- Fax
- (800) 355-1114
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT007535L | PA | Primary |
Addresses
Primary practice location
2250 Hickory Rd Ste 240
Plymouth Meeting, PA 19462-2225
Mailing address
206 Boden St
Carnegie, PA 15106-3106
Phone (412) 576-8612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT007535L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184841702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 BODEN ST",
"city": "CARNEGIE",
"state": "PA",
"postal_code": "151063106",
"telephone_number": "412-576-8612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 HICKORY RD STE 240",
"city": "PLYMOUTH MEETING",
"state": "PA",
"postal_code": "194622225",
"telephone_number": "800-355-1225",
"fax_number": "800-355-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLKA",
"first_name": "SUSAN",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT007535L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth Meeting, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.