Robert J Polacek, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

28524 Issued in KY

Practice address

1 Medical Village Dr
Edgewood, KY 41017-3403

Phone

(859) 301-2000

Fax

(859) 301-2066

NPI assigned

May 31, 2006

Last updated

Aug 31, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Environ Anesthesia, LLC.

  • Anesthesiology Physician
  • Lexington, KY
  • NPI 1831438092
  NPD
• St. Luke Hospitals Inc

  dba St. Luke Physicians for Women

  • Obstetrics & Gynecology Physician
  • Fort Thomas, KY
  • NPI 1902910987
  NPD (past)
• Three Rivers District Health Department

  dba Pendleton County Health Center

  • Public Health or Welfare Agency
  • Falmouth, KY
  • NPI 1073572905
  NPD (past)
• Three Rivers District Health Department

  dba Gallatin County Health Center

  • Public Health or Welfare Agency
  • Warsaw, KY
  • NPI 1548354764
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1326085515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-2000",
            "fax_number": "859-301-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLACEK",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "28524",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "28524",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "28524",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64285240",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID#",
            "identifier": "4198961",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PROVIDER #",
            "identifier": "000000642753",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2239554",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200194410",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Pitts
• Erica R. Pivato, DO
• Jordan Pleasants, RBT
• Debra Poe, RDH
• Olivia Pohlmann
• Ashley Nicole Pope, APRN
• Rebecca E Popham, DO
• Jaise Thekkan Poulose, M.D.
• Shelby Rayne Powell, MS, BCBA, LBA
• Linda Poynter, R.D.H

• Obstetrics & Gynecology Physician in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Obstetrics & Gynecology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.