Individual provider Active NPI

Jason Polonsky, PA

  • Physician Assistant
  • Iowa City, IA
National Provider Identifier
1295797934
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001465 Issued in IA
Practice address
500 E Market St
Iowa City, IA 52245-2633
Phone
(319) 339-0300
Fax
(319) 358-2783
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001465 IA Primary

Addresses

Primary practice location

500 E Market St
Iowa City, IA 52245-2633

Mailing address

625 S Gilbert St
Ste 2
Iowa City, IA 52240-1736
Phone (319) 688-7376

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040730000821 IA Practitioner - Physician Assistant 6507836004 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keokuk County Health CenterGroup PAC ID 0244138774, 23 clinicians

Practice addresses (Care Compare)

23019 Hwy 149
Sigourney, IA 52591-8341
Phone (641) 622-2720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.84 of 100Reported as group
Quality
91.13
Promoting interoperability
100
Improvement activities
40
Cost
81.67

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Keokuk County Health Center CurrentSince Aug 1, 2018 Accepting new patients
Knoxville Community Hospital Inc CurrentSince Mar 14, 2018 Accepting new patients
Van Buren County Hospital CurrentSince Oct 1, 2018 Accepting new patients
Van Buren County Hospital Physician Assistant CurrentSince Oct 1, 2018 Accepting new patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Wapello Emergency Group PC Physician Assistant Past Accepting new patients
Keokuk County Health Center Past Accepting new patients

Locations

304 Franklin St
Keosauqua, IA 52565
Phone (319) 293-3171

1002 S Lincoln St
Knoxville, IA 50138
Phone (641) 842-1464

1314 S Stuart St
Ste B
Sigourney, IA 52591
Phone (641) 622-1148

23019 Highway 149
Sigourney, IA 52591
Phone (641) 622-2720

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

Organizations & group practices 7

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 2

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1295797934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S GILBERT ST",
            "address_2": "STE 2",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522401736",
            "telephone_number": "319-688-7376",
            "fax_number": "319-358-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MARKET ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452633",
            "telephone_number": "319-339-0300",
            "fax_number": "319-358-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLONSKY",
        "first_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.