Active NPI
Laura Christine Polacek, PHD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1457197774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P129387
- Practice address
- 17 E 102ND St
New York, NY 10029-5204 - Phone
- (212) 659-8552
- NPI assigned
- Jul 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P129387 | NY | Primary |
Addresses
Primary practice location
17 E 102ND St
New York, NY 10029-5204
Mailing address
1 Gustave L Levy PL # 1070
New York, NY 10029-6504
Phone (212) 241-3160
Other practice location 1
10 Union Sq E Ste 3G
New York, NY 10003-3314
Phone (212) 463-0101
Other practice location 2
1111 Amsterdam Ave Fl 10
New York, NY 10025-1716
Phone (212) 659-8552
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 658-8552
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P129387 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients |
Locations
10 Union Sq E
Ste 3G
New York, NY 10003
Phone (212) 844-8100
1111 Amsterdam Ave
Fl 10
New York, NY 10025
Phone (212) 523-8672
17 E 102nd St
New York, NY 10029
Phone (212) 241-7968
150 E 42nd St
New York, NY 10017
Phone (212) 661-8139
5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
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.
-
- Geriatric Medicine (Internal Medicine) Physician
- New York, NY
- NPI 1689947160
-
- Eyewear Supplier
- New York, NY
- NPI 1760227466
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Long Island City, NY
- NPI 1245248939
-
- Rehabilitation Hospital
- New York, NY
- NPI 1669440327
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
-
- General Acute Care Hospital
- New York, NY
- NPI 1225295512
-
- General Acute Care Hospital
- New York, NY
- NPI 1104982917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778716800000",
"number": "1457197774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUSTAVE L LEVY PL # 1070",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296504",
"telephone_number": "212-241-3160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 E 102ND ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100295204",
"telephone_number": "212-659-8552"
}
],
"practiceLocations": [
{
"address_1": "10 Union Sq E Ste 3G",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100033314",
"country_code": "US",
"telephone_number": "212-463-0101",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1111 Amsterdam Ave Fl 10",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100251716",
"country_code": "US",
"telephone_number": "212-659-8552",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLACEK",
"first_name": "LAURA",
"middle_name": "CHRISTINE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-05",
"last_updated": "2026-05-14",
"certification_date": "2026-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "P129387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.