Individual provider Active NPI

Shanker Rao Polsani, M.D.,

  • Hematology & Oncology Physician
  • Covington, GA
National Provider Identifier
1184853178
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
89973 Issued in GA
Practice address
5126 Hospital Dr NE
Covington, GA 30014-2566
Phone
(770) 786-7053
NPI assigned
Jul 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 2015-01476 NC
Hematology & Oncology Physician 207RH0003X 89973 GA Primary

Addresses

Primary practice location

5126 Hospital Dr NE
Covington, GA 30014-2566

Mailing address

2100 Stantonsburg Rd
Greenville, NC 27834-2818

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 847-2659

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spolsani276155@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20211012001462 GA Practitioner - Hematology/Oncology 2163672130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

5126 Hospital Dr NE
Covington, GA 30014-2566
Phone (770) 786-7053

Hospital & facility affiliations

  • Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018
  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
  • Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046
  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-01476NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC CurrentSince Nov 15, 2021 Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

Interoperability endpoints

  • Direct secure messaging: spolsani276155@direct.vidanthealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1184853178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 HOSPITAL DR NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142566",
            "telephone_number": "770-786-7053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "27834",
            "country_code": "US",
            "telephone_number": "252-847-2659",
            "fax_number": "252-847-8304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLSANI",
        "first_name": "SHANKER",
        "middle_name": "RAO",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-10",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2015-01476",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "89973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spolsani276155@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

Verify at the official NPI Registry.