Tina Polley

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024172535 Issued in VA

Practice address

14010 Smoketown Rd
Suite 117
Woodbridge, VA 22192-4722

Phone

(703) 580-0181

Fax

(703) 897-8763

NPI assigned

Apr 22, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tina Thieu Former name

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Georgetown University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gastroenterology Associates of Northern Virginia, LLCGroup PAC ID 1759371008, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uva Health Prince William Medical Center Hospital, Manassas, VA, CCN 490045
• Uva Health Haymarket Medical Center Hospital, Haymarket, VA, CCN 490144
• Sentara Northern Virginia Medical Center Hospital, Woodbridge, VA, CCN 490113

Merit-based Incentive Payment System (MIPS)

Final score

80.52 of 100Reported as group

Quality

56.13

Promoting interoperability

98

Improvement activities

40

Cost

80.61

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tina.polley@gastrohealth.eclinicaldirectplus.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.

• Gastroenterology Associates of Northern Virginia, LLC

  • Gastroenterology Physician
  • Fairfax, VA
  • NPI 1205884368

  DC

  Medicare reassignment Care Compare group NPD
• Old Dominion Anesthesia LLC

  • Anesthesiology Physician
  • Charlottesville, VA
  • NPI 1902248677
  NPD (past)

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

• Potomac Hospital Corporation of Prince William

  dba Sentara Northern Virginia Medical Center

  • General Acute Care Hospital
  • Woodbridge, VA
  • NPI 1548366404
  Care Compare affiliation
• Uva Prince William Medical Center

  dba UVA Health Haymarket Medical Center

  • General Acute Care Hospital
  • Haymarket, VA
  • NPI 1124369137
  Care Compare affiliation
• Uva Prince William Medical Center

  dba UVA Health Prince William Medical Center

  • General Acute Care Hospital
  • Manassas, VA
  • NPI 1417005760
  Care Compare affiliation

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1548657117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD",
            "address_2": "SUITE 117",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924722",
            "telephone_number": "703-580-0181",
            "fax_number": "703-897-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD",
            "address_2": "SUITE 117",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924722",
            "telephone_number": "703-580-0181",
            "fax_number": "703-897-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLEY",
        "first_name": "TINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024172535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "THIEU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deborah N Pokoo
• Polaris Heart & Vascular PLLC
• Shriharsh Pole
• Michael Polifko III, DDS
• Jennie Patterson Polizzi, LPC
• Melanie Anne Pooler, RN
• William Pope
• Jenna Popvich, LPC
• David L Postelnek, MD
• Potomac Audiology LLC

• Family Nurse Practitioner in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.