Individual provider Active NPI

Mikhail Podlog, D.O.

  • Emergency Medicine Physician
  • Battle Ground, WA
National Provider Identifier
1558716746
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OP61171512 Issued in WA
Practice address
101 NW 12TH Ave Ste 107
Battle Ground, WA 98604-9141
Phone
(360) 723-0528
Fax
(360) 995-0081
NPI assigned
Apr 26, 2016
Last updated
May 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 296647 NY
Emergency Medicine Physician 207P00000X OP61171512 WA Primary

Addresses

Primary practice location

101 NW 12TH Ave Ste 107
Battle Ground, WA 98604-9141

Mailing address

101 NW 12TH Ave Ste 107
Battle Ground, WA 98604-9141
Phone (360) 723-0528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190618002482 NY Practitioner - Emergency Medicine 8921345463 Reassigns benefits to 1 organization
I20210827002402 WA Practitioner - Emergency Medicine 8921345463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rowan University School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vital Care, PLLCGroup PAC ID 0143712414, 12 clinicians
Emergency Medicine Associates PCGroup PAC ID 3870526858, 37 clinicians

Practice addresses (Care Compare)

101 NW 12TH Ave
Suite 107
Battle Ground, WA 98604-9141
Phone (360) 723-0528

600 NE 92ND Ave
Vancouver, WA 98664-3225
Phone (360) 514-2142

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296647NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Vital Care, PLLC CurrentSince Oct 3, 2025 Accepting new patients
Emergency Medicine Associates PC Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Peacehealth PastSince Sep 1, 2021 Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

972 Brush Hollow Rd
Westbury, NY 11590

101 NW 12th Ave
Ste 107
Battle Ground, WA 98604
Phone (360) 687-6655

600 NE 92nd Ave
Vancouver, WA 98664
Phone (360) 514-2142

Interoperability endpoints

  • Direct secure messaging: mikhail.podlog.1@27390.direct.athenahealth.com

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1558716746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NW 12TH AVE STE 107",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049141",
            "telephone_number": "360-723-0528",
            "fax_number": "360-995-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NW 12TH AVE STE 107",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049141",
            "telephone_number": "360-723-0528",
            "fax_number": "360-995-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODLOG",
        "first_name": "MIKHAIL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "296647",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP61171512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Ground, WA

Sources for this page

Verify at the official NPI Registry.