Individual provider Active NPI

Raymond Polaski, D.C.

  • Chiropractor
  • Newark, DE
National Provider Identifier
1588735443
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
F1-0000551 Issued in DE
Practice address
179 W Chestnut Hill Rd Ste 1&2
Newark, DE 19713-2210
Phone
(302) 317-9309
Fax
(302) 384-7563
NPI assigned
Nov 13, 2006
Last updated
May 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X F1-0000551 DE Primary

Addresses

Primary practice location

179 W Chestnut Hill Rd Ste 1&2
Newark, DE 19713-2210

Mailing address

179 W Chestnut Hill Rd Ste 1&2
Newark, DE 19713-2210
Phone (302) 317-9309

Other practice location 1

2055 Limestone Rd Ste 209A
Wilmington, DE 19808-5536
Phone (302) 317-9309

Other identifiers 10

IdentifierTypeStateIssuer
2155041000OtherDEAMERIHEALTH HMO
680536689OtherDEUNITED HEALTH CARE
3180857OtherDEAETNA HMO
680536689OtherDEBLUE CROSS BLUE SHIELD
1471580OtherDEAMERIHEALTH PPO
680536689OtherDECIGNA
7834488OtherDEAETNA PPO
5897460OtherDEGHI
680536689MedicaidDE
KET6POOtherDECARE FIRST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111111000329 DE Practitioner - Chiropractic 6204000177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glasgow Chiropractic LLCGroup PAC ID 6608867395, 2 clinicians

Practice addresses (Care Compare)

179 W Chestnut Hill Rd
Suite 1And2
Newark, DE 19713-2210
Phone (302) 453-4043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F1-0000551DEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Glasgow Chiropractic LLC Chiropractor CurrentSince Apr 18, 2016 Accepting new patients
Health One P.a. Chiropractor Past Accepting new patients
Carolina Spine and Rehab Chiropractor Past Accepting new patients

Locations

1536 Kirkwood Hwy
Newark, DE 19711
Phone (302) 454-1200

179 W Chestnut Hill Rd
Ste 12
Newark, DE 19713
Phone (302) 317-9309

650 Plaza Dr
Newark, DE 19702
Phone (302) 453-4043

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1588735443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 W CHESTNUT HILL RD STE 1&2",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132210",
            "telephone_number": "302-317-9309",
            "fax_number": "302-384-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 W CHESTNUT HILL RD STE 1&2",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132210",
            "telephone_number": "302-317-9309",
            "fax_number": "302-384-7563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 Limestone Rd Ste 209A",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198085536",
            "country_code": "US",
            "telephone_number": "302-317-9309",
            "fax_number": "302-384-7563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLASKI",
        "first_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-0000551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "2155041000",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "680536689",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3180857",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "680536689",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO",
            "identifier": "1471580",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "680536689",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7834488",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5897460",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "680536689",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST",
            "identifier": "KET6PO",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.