NPIMap

Individual provider Active NPI

Polly Laura Stephens, M.D.

  • Surgery Physician
  • Midlothian, VA
National Provider Identifier
1477664415
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101057448 Issued in VA
Practice address
601 Watkins Centre Parkway
Suite 200
Midlothian, VA 23114
Phone
(804) 594-3130
Fax
(804) 423-6517
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101057448 VA Primary

Addresses

Primary practice location

601 Watkins Centre Parkway
Suite 200
Midlothian, VA 23114

Mailing address

601 Watkins Centre Parkway
Suite 200
Midlothian, VA 23114
Phone (804) 594-3130

Other identifiers 1

IdentifierTypeStateIssuer
010187311MedicaidVA

Other names 1

  • Polly Fatsi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050921000493 VA Practitioner - General SurgeryPractitioner - Other (Physician) 4587698352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Tulane University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13700 St Francis Blvd
Suite 302
Midlothian, VA 23114-3222
Phone (804) 281-8303

1510 N 28TH St
Richmond, VA 23223-5311

210 Medical Park Blvd
Petersburg, VA 23805-9348

40 Medical Park Blvd
Petersburg, VA 23805-9289

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 764-6000

601 Watkins Centre Pkwy
Suite 200
Midlothian, VA 23114-0002
Phone (804) 594-3130

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy45
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC Surgery CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St. Francis Medical Center LLC Past Accepting new patients
Richmond Surgical Group Inc Surgery Past Accepting new patients

Locations

8266 Atlee Rd
Ste 219
Mechanicsville, VA 23116
Phone (804) 594-3130

14051 St Francis Blvd
Ste 2210
Midlothian, VA 23114
Phone (804) 594-3130

13700 St Francis Blvd
Ste 510
Midlothian, VA 23114
Phone (804) 423-8462

601 Watkins Centre Pkwy
Ste 200
Midlothian, VA 23114
Phone (804) 594-3130

210 Medical Park Blvd
Ste 275
Petersburg, VA 23805
Phone (804) 765-5886

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5875 Bremo Rd
Ste 701
Richmond, VA 23226
Phone (804) 282-8350

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

Interoperability endpoints

  • Direct secure messaging: pstephens1156073@direct.bsmhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1477664415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WATKINS CENTRE PARKWAY",
            "address_2": "SUITE 200",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23114",
            "telephone_number": "804-594-3130",
            "fax_number": "804-423-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WATKINS CENTRE PARKWAY",
            "address_2": "SUITE 200",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23114",
            "telephone_number": "804-594-3130",
            "fax_number": "804-423-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "POLLY",
        "middle_name": "LAURA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101057448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010187311",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "POLLY",
            "last_name": "FATSI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.