Kathleen D Polonka, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

02004795A Issued in IN

Practice address

7525 E 82ND St Ste B
Indianapolis, IN 46256-1435

Phone

(317) 621-4600

Fax

(317) 621-4530

NPI assigned

Jun 20, 2013

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

Other identifiers 1

Other names 1

• Kathleen D Biggins Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpolonka387425@ecommunitydirect.com

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244

  Pediatrics

  Medicare reassignment NPD
• Community Physicians of Indiana Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1508205857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 E 82ND ST STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561435",
            "telephone_number": "317-621-4600",
            "fax_number": "317-621-4530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4778 S Scatterfield Rd",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "IN",
            "postal_code": "460132908",
            "country_code": "US",
            "telephone_number": "765-646-6331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4778 S Scatterfield Rd",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "IN",
            "postal_code": "460132908",
            "country_code": "US",
            "telephone_number": "765-646-6331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6905 E 96th St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "46250",
            "country_code": "US",
            "telephone_number": "317-621-6660",
            "fax_number": "317-621-4473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLONKA",
        "first_name": "KATHLEEN",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5315060478",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "02004795A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201349120",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpolonka387425@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7525 E 82nd St Ste B",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462561435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "BIGGINS",
            "middle_name": "D",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Holly Pollock
• James Daniel Pollom, PMHNP-BC
• Robyn K Pollom, NP
• Gregory Paul Polly, M.D.
• James Polly, LCSW
• Angelina Jantina Polsinelli, PHD
• Amy Claire Polsinello
• Nicholas Polster, MD
• Samantha Polster, O.D.
• Marvin Louis Polstra, LCSW

• Pediatrics Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.