Individual provider Active NPI

Kenneth Polezoes, M.D.

  • Family Medicine Physician
  • Crown Point, IN
National Provider Identifier
1366891996
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01082274A Issued in IN
Practice address
7310 W Lincoln Hwy
Crown Point, IN 46307-9528
Phone
(219) 322-4637
Fax
(219) 322-5298
NPI assigned
Jun 4, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 01082274A IN
Family Medicine Physician 207Q00000X 01082274A IN Primary

Addresses

Primary practice location

7310 W Lincoln Hwy
Crown Point, IN 46307-9528

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone (773) 665-6730

Other practice location 2

2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone (773) 665-6730

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kpolezoes65184@ce-direct.presencehealth.org Direct
Direct Messaging Address kpolezoes149526@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20190627000339 IN Practitioner - Family PracticePractitioner - Hospitalist 9335473263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Indiana University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

7310 W Lincoln Hwy
Crown Point, IN 46307-9528
Phone (219) 322-4673

Hospital & facility affiliations

  • Franciscan Home Care Home health agency, Hobart, IN, CCN 157145
  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126
  • Franciscan Health Dyer Hospital, Dyer, IN, CCN 150090
  • Franciscan Health Munster Hospital, Munster, IN, CCN 150165
  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
  • Community Hospital Hospital, Munster, IN, CCN 150125

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Jul 7, 2018 Accepting new patients
Franciscan Physician Network Family Medicine CurrentSince Jul 7, 2018 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

7310 W Lincoln Hwy
Crown Point, IN 46307
Phone (219) 322-3627

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: kpolezoes149526@direct.franciscanalliance.org

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1366891996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 W LINCOLN HWY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079528",
            "telephone_number": "219-322-4637",
            "fax_number": "219-322-5298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575640",
            "country_code": "US",
            "telephone_number": "773-665-6730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575640",
            "country_code": "US",
            "telephone_number": "773-665-6730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLEZOES",
        "first_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-04",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01082274A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01082274A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpolezoes65184@ce-direct.presencehealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7310 W Lincoln Hwy",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpolezoes149526@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7310 W Lincoln Hwy",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.