Lidianny Polanco, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO1984 Issued in AL

Practice address

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457

Phone

(205) 348-1770

NPI assigned

Apr 6, 2016

Last updated

Aug 30, 2019By the provider in NPPES

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 AL

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

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Mountain Group Services, LLCGroup PAC ID 3678886256, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grandview Medical Center Hospital, Birmingham, AL, CCN 010104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/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.

• Oak Mountain Group Services, LLC

  • Hospitalist Physician
  • Birmingham, AL
  • NPI 1366840761
  Medicare reassignment Care Compare group NPD
• Capstone Health Services Foundation PC

  dba University Medical Center

  • Family Medicine Physician
  • Tuscaloosa, AL
  • NPI 1740397751
  Medicare reassignment NPD
• Capstone Health Services Foundation PC

  dba University Medical Center Neurology

  • Neurology Physician
  • Tuscaloosa, AL
  • NPI 1255212353
  NPD
• Oak Mountain Group Services, LLC

  • Physical Medicine & Rehabilitation Physician
  • Vestavia Hills, AL
  • NPI 1609321165
  NPD
• Affinity Hospital LLC

  dba Grandview Medical Center

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1023061405
  NPD (past)

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

• Affinity Hospital LLC

  dba Grandview Medical Center

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1023061405
  Care Compare affiliation

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1548624539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELY PARK BLVD APT 56-2",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051447",
            "telephone_number": "201-401-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017457",
            "telephone_number": "205-348-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Binghamton",
            "state": "NY",
            "postal_code": "139054246",
            "country_code": "US",
            "telephone_number": "607-798-5897",
            "fax_number": "607-798-5839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "LIDIANNY",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO1984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Raymond Plunkett, D.D.S.
• Swati Poddar, M.D.
• Tyler Perry Poe, CRNP
• Courtney Poist
• James Edward Poist, M.D.
• Cheryl Brooke Polinsky, O.D.
• Amanda Lynn Poole, PHARMD
• Leigh Ann Chandler Poole, NP
• Raymond E Poore Jr., M.D.
• James S Pope, RPH

• Family Medicine Physician in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.