Sidney Polzella

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.008665RX Issued in OH

Practice address

4100 W 3Rd St
Dayton, OH 45428-9000

Phone

(268) 651-1937

NPI assigned

Jan 1, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Springfield Medical Care Systems Inc.

  • Federally Qualified Health Center (FQHC)
  • Springfield, VT
  • NPI 1730336843
  Medicare reassignment
• Springfield Medical Care Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Springfield, VT
  • NPI 1457979130
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1577836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1255970786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WOODFIELD PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594629",
            "telephone_number": "513-709-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 3RD ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454289000",
            "telephone_number": "268-651-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLZELLA",
        "first_name": "SIDNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-01",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008665RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra J Pollak
• Kacie Pollet, BS
• Jessika Leigh Polley
• Connie Jean Pollock, L,I.S.W.
• Lynda C Polto
• Pomeroy Properties, Inc.
• Sandra J. Pomeroy, P.T.
• Robert Brandon Ponce, MD
• Alayzia Ponder
• Kavya Pontzloff

• Physician Assistant in Dayton, OH
• Providers in Dayton, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.