Individual provider Active NPI

Polina Sadikov, MD

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1376590091
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-06-7686S Issued in OH
Practice address
9000 N Main St
Suite 300
Dayton, OH 45415-1180
Phone
(937) 832-1500
Fax
(937) 832-0662
NPI assigned
May 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-06-7686S OH Primary

Addresses

Primary practice location

9000 N Main St
Suite 300
Dayton, OH 45415-1180

Mailing address

9000 N Main St
Suite 300
Dayton, OH 45415-1180
Phone (937) 832-1500

Other identifiers 1

IdentifierTypeStateIssuer
0174707MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100208000626 OH Practitioner - Family Practice 6608919923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Family Care IncGroup PAC ID 5092608372, 58 clinicians

Practice addresses (Care Compare)

9000 N Main St
Suite 300
Englewood, OH 45415-1165
Phone (937) 832-1500

Hospital & facility affiliations

  • Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
  • Kettering Homecare Home health agency, Kettering, OH, CCN 367778
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Upper Valley Medical Center Hospital, Troy, OH, CCN 360174

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Family Care Inc Family Medicine CurrentSince Sep 1, 1995 Accepting new patients
Samaritan Family Care Inc Family Medicine CurrentSince Sep 1, 1995 Accepting new patients
Davue OB/GYN Associates, Inc. Past Accepting new patients
Samaritan Family Care, Inc. Family Medicine Past Accepting new patients

Locations

1530 Needmore Rd
Ste 200
Dayton, OH 45414
Phone (937) 278-5854

136 S Ludlow St
#1
Dayton, OH 45402
Phone (937) 499-6745

9000 N Main St
Ste 300
Englewood, OH 45415
Phone (937) 297-6800

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

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.

Hospital & facility affiliations 4

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1376590091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-832-1500",
            "fax_number": "937-832-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-832-1500",
            "fax_number": "937-832-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADIKOV",
        "first_name": "POLINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-06-7686S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0174707",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.