Individual provider Active NPI

Anna Polishchuk, FNP

  • Family Nurse Practitioner
  • Roseville, CA
National Provider Identifier
1447079447
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95032115 Issued in CA
Practice address
701 Sunrise Ave
Roseville, CA 95661-4502
Phone
(916) 772-6337
NPI assigned
Oct 7, 2024
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95032115 CA Primary

Addresses

Primary practice location

701 Sunrise Ave
Roseville, CA 95661-4502

Mailing address

6817 Trailride Way
Citrus Heights, CA 95621-3322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223002587 CA Practitioner - Nurse Practitioner 1153858691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 University Ave
Sacramento, CA 95825-6504
Phone (916) 830-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95032115CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacramento Heart & Vascular Medical Current Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Nov 15, 2024 Accepting new patients
Sacramento Heart & Vascular CurrentSince Nov 1, 2025 Accepting new patients

Locations

2920 Telegraph Ave
Ste 100
Berkeley, CA 94705
Phone (415) 329-3727

4156 Manzanita Ave
Ste 100
Carmichael, CA 95608
Phone (916) 483-5400

401 Grand Ave
#1112
Oakland, CA 94610
Phone (800) 756-4206

701 Sunrise Ave
Roseville, CA 95661
Phone (916) 483-5400

500 University Ave
Sacramento, CA 95825
Phone (916) 423-6806

Interoperability endpoints

  • Direct secure messaging: anna.polishchuk.1@33049.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1447079447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 TRAILRIDE WAY",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956213322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SUNRISE AVE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614502",
            "telephone_number": "916-772-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISHCHUK",
        "first_name": "ANNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.