Individual provider Active NPI

M Polly McKinstry, M D

  • Specialist
  • Laguna Hills, CA
National Provider Identifier
1447269501
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G54934 Issued in CA
Practice address
23961 Calle de la Magdalena Ste 402
Laguna Hills, CA 92653-3685
Phone
(949) 595-0095
Fax
(949) 595-4459
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G54934 CA Primary

Addresses

Primary practice location

23961 Calle de la Magdalena Ste 402
Laguna Hills, CA 92653-3685

Mailing address

23961 Calle de la Magdalena Ste 402
Laguna Hills, CA 92653-3685
Phone (949) 595-0095

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120413000621 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Ophthalmology 3476714619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Ophthalmology
Education
Yale University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1525 Superior Ave
Suite 101
Newport Beach, CA 92663-3639
Phone (949) 595-0095

23961 Calle de la Magdalena
Suite 402
Laguna Hills, CA 92653-3685

Hospital & facility affiliations

  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth19

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
M Polly McKinstry MD Professional Corporation CurrentSince Mar 1, 1997 Accepting new patients
Arthur Astorino Jr MD, a Medical Corporation Past Accepting new patients

Locations

23961 Calle de la Magdalena
Ste 402
Laguna Hills, CA 92653
Phone (949) 595-0095

23521 Paseo de Valencia
Ste 301
Laguna Hills, CA 92653
Phone (949) 595-0095

1525 Superior Ave
Ste 101
Newport Beach, CA 92663
Phone (949) 595-0095

Organizations & group practices 2

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 1

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1447269501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23961 CALLE DE LA MAGDALENA STE 402",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533685",
            "telephone_number": "949-595-0095",
            "fax_number": "949-595-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23961 CALLE DE LA MAGDALENA STE 402",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533685",
            "telephone_number": "949-595-0095",
            "fax_number": "949-595-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINSTRY",
        "first_name": "M POLLY",
        "credential": "M D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G54934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.