Polly J. Hineman, D.O. – Internal Medicine Physician

Key facts

NPI: 1376527606
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
License: 02103 (IA)
Practice address: 401 1St Ave
Toledo, IA 52342-2129
Phone: (641) 484-2602
Fax: (641) 484-6837
NPI assigned: Nov 30, 2005
Sex: Female
Sole proprietor: No

Organizations & group practices 3

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.

Unitypoint Health - Marshalltown Emergency Medicine Physician · Marshalltown, IA · NPI 1164957593

Medicare reassignment NPD IA
Salahuddin Syed MD PC Anatomic Pathology & Clinical Pathology Physician · Marshalltown, IA · NPI 1083054464

NPD
Unitypoint Health - Marshalltown Rural Health Clinic/Center · Waverly, IA · NPI 1124655006

NPD

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Tama Health Care Enterprises LLC Skilled Nursing Facility · Tama, IA · NPI 1558356386

CMS ownership ADP OF THE SNF · OPERATIONAL/MANAGERIAL CONTROL

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facility	Type	Role	Since
Sunny Hill Care Center Tama, IA · CCN 165462	Skilled nursing facility	Operational/Managerial Control Adp of the SNF	Jan 1, 2020 Jan 1, 2020

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20090209000232	IA	Practitioner - Internal Medicine	0547324097	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

State licenses

License	State	Type	Specialty
02103	IA	MD	Internal Medicine Physician

Practice roles

Organization	Status	New patients
Unitypoint Health - Marshalltown	Current since Jul 8, 2019	Accepting new patients
Salahuddin Syed MD PC	Current	Accepting new patients
Unitypoint Health - Marshalltown	Current since Jul 8, 2019	Accepting new patients

Locations

405 E Main St
Marshalltown, IA 50158
Phone (641) 753-2752

55 Unitypoint Way
Marshalltown, IA 50158
Phone (641) 754-5145

1307 S Broadway St
Toledo, IA 52342
Phone (641) 484-5253

Interoperability endpoints

Direct secure messaging: pollyhineman@grmc.allscriptsdirect.net

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician	207R00000X	02103	IA	Yes

Addresses

Primary practice location

401 1St Ave
Toledo, IA 52342-2129

Mailing address

401 1St Ave
Toledo, IA 52342-2129
Phone (641) 484-2602

Other providers in Toledo, IA

All providers in Toledo, IA · Internal Medicine Physician in Iowa

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.