Mary Kay Polsemen, D.C.

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

23832 Issued in CA

Practice address

3150 Crow Canyon PL
Ste 120
San Ramon, CA 94583-1778

Phone

(925) 830-8635

Fax

(925) 830-8652

NPI assigned

Jun 8, 2005

Last updated

Jul 9, 2010By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Figone Chiropractic, Inc.

  dba Absolute Chiropractic

  • Chiropractor
  • Alamo, CA
  • NPI 1902993165
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1275537177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 CROW CANYON PL",
            "address_2": "STE 120",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831778",
            "telephone_number": "925-830-8635",
            "fax_number": "925-830-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CROW CANYON PL",
            "address_2": "STE 120",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831778",
            "telephone_number": "925-830-8635",
            "fax_number": "925-830-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSEMEN",
        "first_name": "MARY KAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "23832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CY272A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Playdates. Soft Indoor Playlounge
• Pleasant Care Medical Associates
• Pleasanton Diagnostic Imaging, Inc.
• Pleasanton Family Medical Center, Inc.
• Jennifer Polite
• Alexis Pommier Tu, PPS
• Linda Pon, ATC
• Pontine Incorporated
• Erin Pontius
• Porter Ambulatory Surgery Center, LLC

• Nutrition Chiropractor in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Nutrition Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.