Individual provider Active NPI

Brian Christopher Policano, MD

  • Pediatrics Physician
  • Bridgeport, WV
National Provider Identifier
1366459299
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
WV21260 Issued in WV
Practice address
7 Chenoweth Dr
Suite a
Bridgeport, WV 26330-1887
Phone
(304) 842-5777
Fax
(304) 842-3318
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X WV21260 WV Primary

Addresses

Primary practice location

7 Chenoweth Dr
Suite a
Bridgeport, WV 26330-1887

Mailing address

PO Box 763
Morgantown, WV 26507-0763
Phone (800) 541-4009

Other identifiers 2

IdentifierTypeStateIssuer
01720854OtherWVBC/BS
3004243000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20170606001895 WV Practitioner - Pediatric Medicine 5092082438 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
WV21260WVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Physicians Care Inc CurrentSince May 8, 2017 Accepting new patients
United Physicians Care Inc Pediatrics CurrentSince May 8, 2017 Accepting new patients
United Hospital Center, Inc Past Accepting new patients
St Josephs Hospital of Buckhannon Inc Past Accepting new patients

Locations

7 Chenoweth Dr
Bridgeport, WV 26330
Phone (304) 842-3318

1370 Johnson Ave
Ste 102
Bridgeport, WV 26330
Phone (681) 342-3452

7 Chenoweth Dr
Ste A
Bridgeport, WV 26330
Phone (304) 842-5777

2373 W Main St
Ste 102
Salem, WV 26426
Phone (304) 782-2000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1366459299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 763",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070763",
            "telephone_number": "800-541-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CHENOWETH DR",
            "address_2": "SUITE A",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301887",
            "telephone_number": "304-842-5777",
            "fax_number": "304-842-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICANO",
        "first_name": "BRIAN",
        "middle_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "WV21260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "01720854",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004243000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.