Michael J Polski MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H9592 Issued in TX

Legal business name

MICHAEL J POLSKI MD PA

Practice address

1310 NW John Jones Dr
Burleson, TX 76028-8040

Phone

(817) 297-1297

Fax

(817) 297-6363

NPI assigned

Nov 2, 2011

Last updated

Nov 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Polski, M.D.NPI 1952342487

Title

Ceo/Owner

Phone

(817) 297-1297

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael J. Polski, M.D.

  • Family Medicine Physician
  • Burleson, TX
  • NPI 1952342487
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1417233586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 NW JOHN JONES DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288040",
            "telephone_number": "817-297-1297",
            "fax_number": "817-297-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 NW JOHN JONES DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288040",
            "telephone_number": "817-297-1297",
            "fax_number": "817-297-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J POLSKI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "POLSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "817-297-1297",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H9592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139817405",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139817420",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Burleson, TX
• Providers in Burleson, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.