Stevan A Polus

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALH11503H Issued in AZ

Practice address

10430 W Royal Palm Rd
Peoria, AZ 85345

Phone

(602) 481-8746

Fax

(623) 440-5381

NPI assigned

May 15, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Peoria Vista Care LLC

  • Assisted Living Facility
  • Peoria, AZ
  • NPI 1912659178
  NPD Authorized official

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1588413231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10430 W ROYAL PALM RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85345",
            "telephone_number": "602-481-8746",
            "fax_number": "623-440-5381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10430 W ROYAL PALM RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85345",
            "telephone_number": "602-481-8746",
            "fax_number": "623-440-5381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLUS",
        "first_name": "STEVAN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALH11503H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Poach, OTD, OTR/L
• Alyssa Kay Poland, PA-C
• Lindsay Polk, PSY.D.
• Nino Demetrius Pollaccia, DDS
• Thomas Weldon Pollard, DO
• Polyclinic Pharmacy Inc. (A2Z DME)
• Shelby Poole
• Dorin T Popa, MD
• Catrina Popelier, MPH RN IBCLC
• Shawna Louise Porumb, RN

• Assisted Living Facility in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.