Active NPI
Andrew Polony, M.D.
- Diagnostic Radiology Physician
- Peabody, MA
National Provider Identifier
1316930423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 169655
- Practice address
- 10 Dearborn Rd
Peabody, MA 01960-8836 - Phone
- (978) 998-6821
- NPI assigned
- Aug 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 169655 | NY | Primary |
Addresses
Primary practice location
10 Dearborn Rd
Peabody, MA 01960-8836
Mailing address
10 Dearborn Rd
Peabody, MA 01960-8836
Phone (978) 998-6821
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01089298 | Medicaid | NY | |
| P00337162 | Other | NY | RR MEDICARE PIN |
| GU039853 | Other | PA | PA MEDICARE GROUP |
| GU058887 | Other | PA | PA MEDICARE GROUP |
| 1017988430001 | Medicaid | PA | |
| CC8362 | Other | NY | RR MEDICARE GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416441600000",
"number": "1316930423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 DEARBORN RD",
"city": "PEABODY",
"state": "MA",
"postal_code": "019608836",
"telephone_number": "978-998-6821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 DEARBORN RD",
"city": "PEABODY",
"state": "MA",
"postal_code": "019608836",
"telephone_number": "978-998-6821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLONY",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2014-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NY",
"license": "169655",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01089298",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "P00337162",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA MEDICARE GROUP",
"identifier": "GU039853",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA MEDICARE GROUP",
"identifier": "GU058887",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1017988430001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC8362",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.