Kenneth D Polivy, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

47345 Issued in MA

Practice address

2000 Washington St
Suite 341
Newton, MA 02462-1650

Phone

(617) 964-0024

Fax

(617) 964-6374

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Orthopedic Surgery

Education

Tufts University School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Newton Wellesley Orthopedic Associates IncGroup PAC ID 0042287591, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Hill Home Health Care Inc Home health agency, Needham, MA, CCN 227462
• Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
• Emerson Hospital - Hospital, W Concord, MA, CCN 220084
• Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: polivy.kenneth.nwoa@direct.partners.masshiway.net

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.

• Newton Wellesley Orthopedic Associates Inc

  • Orthopaedic Surgery Physician
  • Newton, MA
  • NPI 1356430896
  Medicare reassignment Care Compare group NPD
• Lighthouse Surgical Suites, LLC

  • Ambulatory Surgical Clinic/Center
  • Hollis, NH
  • NPI 1932700085
  NPD

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

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation
• Emerson Hospital

  • General Acute Care Hospital
  • Concord, MA
  • NPI 1922103357
  Care Compare affiliation
• Newton-Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1992737761
  Care Compare affiliation
• North Hill Home Health Care, Inc.

  • Home Health Agency
  • Needham, MA
  • NPI 1205278389
  Care Compare affiliation

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1194794115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 WASHINGTON ST",
            "address_2": "SUITE 341",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621650",
            "telephone_number": "617-964-0024",
            "fax_number": "617-964-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WASHINGTON ST",
            "address_2": "SUITE 341",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621650",
            "telephone_number": "617-964-0024",
            "fax_number": "617-964-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIVY",
        "first_name": "KENNETH",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "47345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6183484",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "17266",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "047345",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J03453",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Point and Balance LLC
• Point and Balance LLC
• Sebastien Poirier
• Marla P Polger, MD
• Robin Polishook
• Alan S Pollack, M.D.
• Anna Pollard, LICSW
• Elizabeth Pond
• Nancy Levitan Poorvu, M.S.W., L.I.C.S.W.
• Andrew Popper, M.D.

• Orthopaedic Surgery Physician in Newton, MA
• Providers in Newton, MA by specialty
• Orthopaedic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.