Individual provider Active NPI

Ruth L Polan, MD

  • Diagnostic Radiology Physician
  • Thousand Oaks, CA
National Provider Identifier
1629048350
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G44076 Issued in CA
Practice address
227 W Janss Rd
Suite 150
Thousand Oaks, CA 91360-1848
Phone
(805) 496-7755
Fax
(805) 379-3913
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G44076 CA Primary

Addresses

Primary practice location

227 W Janss Rd
Suite 150
Thousand Oaks, CA 91360-1848

Mailing address

2190 Lynn Rd
Suite 220
Thousand Oaks, CA 91360-1980
Phone (805) 495-8050

Other identifiers 1

IdentifierTypeStateIssuer
00G447060MedicaidCA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20081110000174 CA Practitioner - Diagnostic Radiology 6002701158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Jefferson Medical College of Thomas Jefferson University, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thousand Oaks Diagnostic Imaging CenterGroup PAC ID 6305983669, 10 clinicians
West Valley Radiology Medical Group IncGroup PAC ID 1658266622, 42 clinicians

Practice addresses (Care Compare)

2180 Lynn Rd
Thousand Oaks, CA 91360-1916
Phone (805) 796-7755

227 W Janss Rd
Suite 150
Thousand Oaks, CA 91360-1859
Phone (805) 496-7755

3421 Deep Waters CT
Simi Valley, CA 93065-0587
Phone (855) 504-4544

Hospital & facility affiliations

  • Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549

Merit-based Incentive Payment System (MIPS)

Final score
91.96 of 100Reported as group
Quality
93.25
Improvement activities
40
Cost
79.74

Merit-based Incentive Payment System (MIPS)

Final score
89.78 of 100Reported as group
Quality
80
Improvement activities
40
Cost
75.29

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44076CAMDMarriage & Family Therapist
G44076CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thousand Oaks Diagnostic Imaging Center Diagnostic Radiology CurrentSince Jul 30, 2009 Accepting new patients
Thousand Oaks Diagnostic Imaging Center Diagnostic Radiology CurrentSince Jul 30, 2009 Accepting new patients
West Valley Radiology Medical Group, Inc. Diagnostic Radiology CurrentSince Mar 6, 2024 Accepting new patients
Teviah Turkat a Medical Corporation Diagnostic Radiology Past Accepting new patients

Locations

227 W Janss Rd
Ste 150
Thousand Oaks, CA 91360
Phone (805) 496-7755

2180 Lynn Rd
Thousand Oaks, CA 91360
Phone (805) 495-9442

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

2190 Lynn Rd
Ste 100
Thousand Oaks, CA 91360
Phone (805) 373-8878

2190 Lynn Rd
Ste 220
Thousand Oaks, CA 91360
Phone (805) 495-8050

558 Saint Charles Dr
Ste 111
Thousand Oaks, CA 91360
Phone (805) 230-2700

7300 Medical Ctr
West Hills, CA 91307
Phone (818) 612-8301

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1629048350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 LYNN RD",
            "address_2": "SUITE 220",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601980",
            "telephone_number": "805-495-8050",
            "fax_number": "805-496-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W JANSS RD",
            "address_2": "SUITE 150",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601848",
            "telephone_number": "805-496-7755",
            "fax_number": "805-379-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAN",
        "first_name": "RUTH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G44076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G447060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.