Michelle Polyak

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00875900 Issued in NJ

Practice address

801 Lexington Ave Apt 4a
Lakewood, NJ 08701-2861

Phone

(610) 715-6567

NPI assigned

Dec 13, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Director Services PCGroup PAC ID 0042501116, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Medical Director Services PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Princess Anne, MD
  • NPI 1871955807

  NJ

  Medicare reassignment Care Compare group
• Vitalpoint Healthpc

  • Internal Medicine Physician
  • Hammonton, NJ
  • NPI 1205719820
  Medicare reassignment NPD

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1447961255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 LEXINGTON AVE APT 4A",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 LEXINGTON AVE APT 4A",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012861",
            "telephone_number": "610-715-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLYAK",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00875900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tova E Pollack, LMSW
• Chana Pollak, RN
• Chaya Pollak, LSW
• Yocheved Pollak, MS
• Masha Polter, MA, SLP
• Irene Pomper, M.S., CCC
• Pasquale Michael Pontoriero, PHARMD, RPH, CCP
• Rachel Marie Poole
• Adeola Olatunji Popoola, PT,MED
• Bolanle Popoola, APN

• Medical Physician Assistant in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.