Elena Poloukhine, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

047206 Issued in CT

Practice address

12 Lathrop Rd
Plainfield, CT 06374-2061

Phone

(860) 457-9209

Fax

(860) 457-9201

NPI assigned

May 1, 2007

Last updated

Jan 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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 CT

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

Specialty

Obstetrics/Gynecology

Education

Rush Medical College of Rush University, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Day Kimball Medical Group IncGroup PAC ID 1557514411, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Day Kimball Hospital Hospital, Putnam, CT, CCN 070003

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elena.poloukhine.1@1694.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4

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.

• Day Kimball Medical Group Inc

  • Family Medicine Physician
  • Putnam, CT
  • NPI 1376813972
  Medicare reassignment Care Compare group NPD
• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1649243478
  Medicare reassignment NPD
• Day Kimball Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Putnam, CT
  • NPI 1104680966
  NPD
• Day Kimball Healthcare, Inc.

  • Community Health Clinic/Center
  • Putnam, CT
  • NPI 1265540967
  NPD
• University Pathologists, LLC

  • Anatomic Pathology Physician
  • Providence, RI
  • NPI 1568640886
  NPD
• University Plaza Obstetrics & Gynecology, LLP

  • Obstetrics & Gynecology Physician
  • Garden City, NY
  • NPI 1255456745
  NPD (past)

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

• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1205056371
  Care Compare affiliation
• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1649243478
  Care Compare affiliation

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1487874483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 LATHROP RD",
            "city": "PLAINFIELD",
            "state": "CT",
            "postal_code": "063742061",
            "telephone_number": "860-457-9209",
            "fax_number": "860-457-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LATHROP RD",
            "city": "PLAINFIELD",
            "state": "CT",
            "postal_code": "063742061",
            "telephone_number": "860-457-9209",
            "fax_number": "860-457-9201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "877 Stewart Ave",
            "address_2": "Suite 7",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "NY",
            "postal_code": "115304803",
            "country_code": "US",
            "telephone_number": "516-222-0722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLOUKHINE",
        "first_name": "ELENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "222823",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CT",
            "license": "047206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Joan Pelish-Sundstrom, LMSW
• Plainfield Family Chiropractic, LLC
• Plainfield Public Schools
• Plainfield SNF Opco LLC (Villa Maria Nursing and Rehabilitation Community)
• Plainfield Walk in Medical Center LLC
• Premise Health of Connecticut Medical PC (My Health Center At Lowe's Plainfield)
• Quality Homemakers Ma, LLC
• Quality Homemakers, Inc
• Tucker William Romans
• Cherie A Sage, APRN

• Gynecology Physician in Plainfield, CT
• Providers in Plainfield, CT by specialty
• Gynecology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.