Individual provider Active NPI

Caterina Maria Polina, PA

  • Physician Assistant
  • Royal Oak, MI
National Provider Identifier
1255924643
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012389 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073
Phone
(248) 898-1994
NPI assigned
Feb 16, 2021
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601012389 MI
Physician Assistant 363A00000X 10003368A IN
Physician Assistant 363A00000X 5601012389 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6000

Other practice location 2

3565 Port Cove Dr Apt 71
Waterford, MI 48328-4578
Phone (586) 945-6937

Other practice location 3

11104 Parkview Circle Dr Ste 410
Fort Wayne, IN 46845-0025
Phone (260) 266-2020

Other names 1

  • Caterina Elliott Former name

Electronic endpoints 4

TypeEndpointUseAffiliation
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/
Direct Messaging Address celliott471284@Direct.Parkviewexchange.com
Direct Messaging Address celliott1456483@epic00.shdirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210920000949 IN Practitioner - Physician Assistant 3173920048 Reassigns benefits to 1 organization
I20240611000865 MI Practitioner - Physician Assistant 3173920048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, 194 clinicians
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

2070 Biddle Ave
Suite 2
Wyandotte, MI 48192-4080
Phone (734) 284-7482

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6000

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601012389MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Wyandotte Hospital CurrentSince Jun 4, 2024 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Jun 4, 2024 Accepting new patients
Parkview Health System Inc CurrentSince Sep 2, 2021 Accepting new patients

Locations

11104 Parkview Circle Dr
Ste 410
Fort Wayne, IN 46845
Phone (260) 266-5260

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Interoperability endpoints

  • Direct secure messaging: celliott1456483@epic00.shdirect.org
  • Direct secure messaging: celliott471284@direct.parkviewexchange.com
  • Direct secure messaging: celliott655653@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1255924643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48073",
            "telephone_number": "248-898-1994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2333 Biddle Ave",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "MI",
            "postal_code": "481924668",
            "country_code": "US",
            "telephone_number": "734-246-6000",
            "fax_number": "313-876-1305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3565 Port Cove Dr Apt 71",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483284578",
            "country_code": "US",
            "telephone_number": "586-945-6937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11104 Parkview Circle Dr Ste 410",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468450025",
            "country_code": "US",
            "telephone_number": "260-266-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLINA",
        "first_name": "CATERINA",
        "middle_name": "MARIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601012389",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003368A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 410",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468450025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 410",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468450025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "celliott471284@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 410",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468450025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "celliott1456483@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CATERINA",
            "last_name": "ELLIOTT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.