Individual provider Active NPI

Noelle Polniak, N.P.

  • Women's Health Nurse Practitioner
  • Canton, NY
National Provider Identifier
1598008229
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
F421117-1 Issued in NY
Practice address
4 Commerce LN
Canton, NY 13617-3739
Phone
(315) 386-8191
NPI assigned
Apr 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X F421117-1 NY Primary

Addresses

Primary practice location

4 Commerce LN
Canton, NY 13617-3739

Mailing address

4 Commerce LN
Canton, NY 13617-3739
Phone (315) 386-8191

Other identifiers 1

IdentifierTypeStateIssuer
03574563MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160324000728 NY Practitioner - Nurse Practitioner 4486951126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canton-Potsdam HospitalGroup PAC ID 6204827280, 243 clinicians

Practice addresses (Care Compare)

190 Outer Main St
Potsdam, NY 13676-2356
Phone (315) 265-2153

4 Commerce LN
Canton, NY 13617-3739
Phone (315) 386-8191

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F421117-1NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Association of the North Country, Inc. CurrentSince Dec 15, 2025 Accepting new patients
Canton-Potsdam Hospital CurrentSince Feb 29, 2016 Accepting new patients
Canton-Potsdam Hospital CurrentSince Feb 29, 2016 Accepting new patients
Canton Potsdam Hospital Past Accepting new patients

Locations

4 Commerce Ln
Canton, NY 13617
Phone (315) 386-1156

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

49 Lawrence Ave
Potsdam, NY 13676
Phone (315) 261-5550

190 Outer Main St
Potsdam, NY 13676
Phone (315) 265-1095

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

Interoperability endpoints

  • Direct secure messaging: npolniak337448@direct.rochesterregional.org
  • Direct secure messaging: noelle.polniak.p2@direct.usppny.nextgenshare.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1598008229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COMMERCE LN",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173739",
            "telephone_number": "315-386-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COMMERCE LN",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173739",
            "telephone_number": "315-386-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLNIAK",
        "first_name": "NOELLE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "F421117-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03574563",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, NY

Sources for this page

Verify at the official NPI Registry.