Mike Polewski, PA

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

5601009538 Issued in MI

Practice address

41800 Hayes Rd Ste 126
Clinton Township, MI 48038-1876

Phone

(586) 843-7996

NPI assigned

Jul 29, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mike.polewski.1@18731.direct.athenahealth.com

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.

• County of Macomb

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clinton TWP, MI
  • NPI 1942532197

  Single Specialty

  Medicare reassignment NPD
• Inhospital Physicians Michigan PLLC

  • Internal Medicine Physician
  • Port Huron, MI
  • NPI 1427840586

  Single Specialty

  Medicare reassignment NPD
• Kolbe Health Clinic PLLC

  • Addiction Medicine (Internal Medicine) Physician
  • Mount Clemens, MI
  • NPI 1871352583
  NPD Authorized official
• Huron Emergency Medicine Specialists, PLLC

  • Emergency Medicine Physician
  • Port Huron, MI
  • NPI 1528686540
  Medicare reassignment
• Orion Family Physicians PC

  • Family Medicine Physician
  • Lake Orion, MI
  • NPI 1578627816
  Medicare reassignment
• Wellstreet Urgent Care of Michigan

  • Urgent Care Clinic/Center
  • West Bloomfield, MI
  • NPI 1578048096
  Medicare reassignment
• County of Macomb

  • Public Health or Welfare Agency
  • Mount Clemens, MI
  • NPI 1760462253
  NPD
• Wellstreet Urgent Care of Michigan

  • Non-Pharmacy Dispensing Site
  • Troy, MI
  • NPI 1649952052
  NPD (past)
• Bicycle Health Medical Group PA

  • Addiction Medicine (Family Medicine) Physician
  • Seattle, WA
  • NPI 1194342162

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708732800000",
    "number": "1336793264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39581 OLD DOMINION DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480382650",
            "telephone_number": "586-843-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 HAYES RD STE 126",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381876",
            "telephone_number": "586-843-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEWSKI",
        "first_name": "MIKE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-29",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5601009538",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009538",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MI",
            "license": "5601009538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Thomas Plunkett, DDS,MS
• Laurie Ann Pocius
• Erica Rae Podsiadly, BA
• Mary-Anne Angeline Polan, OTR
• Guillermo Polanco Serra, MD
• John Polyzois, DO
• Leon Popaj, MD
• Haley Melissa Pope, DO
• Kyler James Popp, OD
• Port Huron Therapy Center LLC

• Addiction Medicine (Internal Medicine) Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Addiction Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.