Individual provider Active NPI

Catherine Coss Polley, MD, MPH

  • Emergency Medicine Physician
  • Fort Sam Houston, TX
National Provider Identifier
1194176883
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
U6704 Issued in TX
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-4141
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301110493 MI
Emergency Medicine Physician 207P00000X U6704 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-4141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, DC, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200224000310 MS Practitioner - Emergency Medicine 4486940574 Reassigns benefits to 1 organization
I20220915000833 DC Practitioner - Emergency Medicine 4486940574 Reassigns benefits to 1 organization
I20231111000650 TX Practitioner - Emergency Medicine 4486940574 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301110493MIMDEmergency Medicine Physician
U6704TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Oct 18, 2023 Accepting new patients
App of Mississippi Ed, LLC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
Mep Health, LLC Emergency Medicine CurrentSince Aug 6, 2022 Accepting new patients

Locations

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

Interoperability endpoints

  • Direct secure messaging: ccoss597988@direct.centracare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1194176883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLEY",
        "first_name": "CATHERINE",
        "middle_name": "COSS",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301110493",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "U6704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.