Individual provider Active NPI

Frinny R Polanco Walters, M.D.

  • Pediatric Adolescent Medicine Physician
  • Dorchester, MA
National Provider Identifier
1366855306
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
269921 Issued in MA
Practice address
230 Bowdoin St
Dorchester, MA 02122-1817
Phone
(617) 754-0100
Fax
(617) 754-0230
NPI assigned
Jun 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 269921 MA Primary

Addresses

Primary practice location

230 Bowdoin St
Dorchester, MA 02122-1817

Mailing address

230 Bowdoin St
Dorchester, MA 02122-1817
Phone (617) 754-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200707002128 MA Practitioner - Pediatric Medicine 5991094104 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Mar 23, 2025 Accepting new patients
Children'S Hospital Pediatric Associates, Inc Pediatrics CurrentSince Aug 5, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Mar 23, 2025 Accepting new patients
Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

230 Bowdoin St
Dorchester, MA 02122
Phone (617) 754-0100

Interoperability endpoints

  • Direct secure messaging: fpolancowalters486554@direct.bilh.masshiway.net
  • Direct secure messaging: fpolancowalters27822@direct.bostonchildrens.org

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": "1402099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1366855306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 BOWDOIN ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021221817",
            "telephone_number": "617-754-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 BOWDOIN ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021221817",
            "telephone_number": "617-754-0100",
            "fax_number": "617-754-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO WALTERS",
        "first_name": "FRINNY",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-07",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MA",
            "license": "269921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.