Polly Love McCormack, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

28473 Issued in MN

Practice address

5851 Duluth St
Ste 215
Golden Valley, MN 55422-3956

Phone

(763) 546-8422

Fax

(763) 546-8114

NPI assigned

Jun 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Ophthalmology

Education

University of Rochester School of Medicine and Dentistry, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• West Metro Ophthalmology, PA

  • Ophthalmology Physician
  • Monticello, MN
  • NPI 1760523518
  NPD

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1376549089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 DULUTH ST",
            "address_2": "STE 215",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223956",
            "telephone_number": "763-546-8422",
            "fax_number": "763-546-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 DULUTH ST",
            "address_2": "STE 215",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223956",
            "telephone_number": "763-546-8422",
            "fax_number": "763-546-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "POLLY",
        "middle_name": "LOVE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "28473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "54817MC",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "0818315",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "967888300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180009769",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth B McAllister
• Aaron Michael McBroom, PT
• Christine Marie McCann
• Laura McCarthy
• Collin Matthew McClelland, MD
• Melia Joy McCubbin, MSW, LICSW
• Morgan McDowell, MSW, LICSW
• Debra Lynn McGuffee, MA, LMFT
• Yvonne Tora McIntosh, LICSW
• Steven Michael McManus, LMFT

• Ophthalmology Physician in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.