Individual provider Active NPI

Jason Alexander Polanco

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1215874813
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C020031 Issued in NC
Practice address
1301 Fayetteville St
Durham, NC 27707-2398
Phone
(919) 956-4059
NPI assigned
May 1, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C020031 NC Primary

Addresses

Primary practice location

1301 Fayetteville St
Durham, NC 27707-2398

Mailing address

1301 Fayetteville St
Durham, NC 27707-2398
Phone (919) 956-4059

Medicare participation

Medicare enrollment files
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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1301 Fayetteville St
Durham, NC 27707-2325

1301 Fayetteville St
Durham, NC 27707-2398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C020031NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1777593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1215874813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072398",
            "telephone_number": "919-956-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072398",
            "telephone_number": "919-956-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "JASON",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-01",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C020031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.