Gayle Copeland Polsky, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A110133 Issued in CA

Practice address

450 Newport Center Dr Ste 380
Newport Beach, CA 92660-7613

Phone

(310) 613-3469

NPI assigned

Apr 5, 2010

Last updated

Nov 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 22, 2019 through Feb 22, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Matthew N. Koury, MD, MPH a Professional Corporation

  dba Mind Health Institute, Newport Beach

  • Child & Adolescent Psychiatry Physician
  • Newport Beach, CA
  • NPI 1154864205
  NPD (past)

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1184949042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 NEWPORT CENTER DR STE 380",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607613",
            "telephone_number": "310-613-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NEWPORT CENTER DR STE 380",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607613",
            "telephone_number": "310-613-3469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 Alcazar Street",
            "address_2": "Suite 2200",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90033",
            "country_code": "US",
            "telephone_number": "323-442-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLSKY",
        "first_name": "GAYLE",
        "middle_name": "COPELAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A110133",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A110133",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pollack Chiropractic Group, Inc
• Kimberly Ann Pollard Johnson, LMFT LPCC
• Mary Elizabeth Pollaro, MED, AMFT
• Polny Chiropractic Corporation (Natural Health Center)
• Bohdan Stephan Polny, D.C.
• Polyviou Dental Corportation, Inc.
• Marlene Melero Pompa
• Jason Pon, M.S.
• Christian-Jeff Mistica Pontiga
• Jessica Ann Poole

• Psychiatry Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.