Dedrie M Polakof, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

2654 Issued in AZ

Practice address

13041 N del Webb Blvd
Sun City, AZ 85351-3034

Phone

(623) 977-7201

NPI assigned

Jan 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Cigna Health Care of Arizona Inc.

  dba CMG Sun City Healthcare Center, Sun City

  • Clinic/Center
  • Sun City, AZ
  • NPI 1952472672
  NPD (past)
• Cigna Healthcare of Arizona, Inc.

  dba EVERNORTH Care Group

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1073626404
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205806973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13041 N DEL WEBB BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513034",
            "telephone_number": "623-977-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13041 N DEL WEBB BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513034",
            "telephone_number": "623-977-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAKOF",
        "first_name": "DEDRIE",
        "middle_name": "M",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "2654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "701012",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pinnacle Medical Associates LLC (Tarandeep S. Grewal, MD)
• Pinnacle Vein and Vascular Center PLLC
• John Pisacano, SCHOOL PSYCHOLOGIST
• Daniela Plascencia, BCBA
• Robert Plass, M.D
• Aleksey Polyakov, D.C.
• Apichan Pootrakul, MD
• Virginia Pop, CPHT CERTIFIED PHARM
• Ron L Porter, OT
• Jessica Julia Powell, PSY. D.

• Podiatrist in Sun City, AZ
• Providers in Sun City, AZ by specialty
• Podiatrist in Arizona

• 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.

Verify at the official NPI Registry.