Individual provider Active NPI

Erin L Polczynski, MD

  • Family Medicine Physician
  • Hartford, WI
National Provider Identifier
1275776155
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
56200 Issued in WI
Practice address
1640 E Sumner St
Hartford, WI 53027-2684
Phone
(262) 369-7040
Fax
(262) 367-8744
NPI assigned
Apr 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 56200 WI Primary

Addresses

Primary practice location

1640 E Sumner St
Hartford, WI 53027-2684

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1500 Walnut Ridge Dr
ProHealth Care Medical Associates
Hartland, WI 53029-9317
Phone (262) 928-7500

Other identifiers 1

IdentifierTypeStateIssuer
100023705MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address epolczynski221128@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20120813000372 WI Practitioner - Family Practice 6204082993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56200WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. Family Medicine CurrentSince Jan 28, 2019 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jan 28, 2019 Accepting new patients
Prohealth Medical Group Inc Family Medicine Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

1640 E Sumner St
Hartford, WI 53027
Phone (262) 670-4000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

Organizations & group practices 3

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.

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": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1275776155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 E SUMNER ST",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530272684",
            "telephone_number": "262-369-7040",
            "fax_number": "262-367-8744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Walnut Ridge Dr",
            "address_2": "ProHealth Care Medical Associates",
            "address_purpose": "LOCATION",
            "city": "Hartland",
            "state": "WI",
            "postal_code": "530299317",
            "country_code": "US",
            "telephone_number": "262-928-7500",
            "fax_number": "262-367-8744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLCZYNSKI",
        "first_name": "ERIN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-08",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "56200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100023705",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "epolczynski221128@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1640 E Sumner St",
            "city": "Hartford",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530272684",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1640 E Sumner St",
            "city": "Hartford",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530272684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, WI

Sources for this page

Verify at the official NPI Registry.