Individual provider Active NPI

Joel Poliskey, MD

  • Emergency Medicine Physician
  • Marquette, MI
National Provider Identifier
1255960985
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4351046589 Issued in MI
Practice address
850 W Baraga Ave
Marquette, MI 49855-4550
Phone
(906) 449-3000
NPI assigned
Apr 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 4351046589 MI Primary

Addresses

Primary practice location

850 W Baraga Ave
Marquette, MI 49855-4550

Mailing address

850 W Baraga Ave
Marquette, MI 49855-4550
Phone (906) 449-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20221117000246 MI Practitioner - Emergency Medicine 3072937283 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Jun 15, 2023 Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Baraga County Memorial Hospital CurrentSince Nov 1, 2024 Accepting new patients
Ecs Central Michigan PC Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Ecs Western Michigan PC Emergency Medicine CurrentSince Sep 14, 2022 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Jun 15, 2023 Accepting new patients
Baraga County Memorial Hospital Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients

Locations

100 Michigan St NE
#49
Grand Rapids, MI 49503
Phone (616) 391-1680

615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341

18341 US Highway 41
Lanse, MI 49946
Phone (906) 524-3300

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

Organizations & group practices 8

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": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1255960985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W BARAGA AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554550",
            "telephone_number": "906-449-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W BARAGA AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554550",
            "telephone_number": "906-449-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISKEY",
        "first_name": "JOEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-04",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4351046589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.