Mark Benedict Polles, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN-165625 Issued in CO

Practice address

5637 Marine Pkwy
New Port Richey, FL 34652-4316

Phone

(727) 848-1733

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Florida Em-I Medical Services PA

  • Emergency Medicine Physician
  • Lakeland, FL
  • NPI 1871542720
  NPD (past)
• Florida Institute of Family Medicine, PA

  • Family Medicine Physician
  • St Petersburg, FL
  • NPI 1639285141
  NPD (past)
• Osprey Emergency Physicians LLC

  • Emergency Medicine Physician
  • Lakeland, FL
  • NPI 1063461960
  NPD (past)
• Department of Human Services & PHS, IHS

  • Durable Medical Equipment & Medical Supplies
  • Cass Lake, MN
  • NPI 1659404051
  NPD (past)
• Department of Human Services &PHS, IHS

  • Federal Public Health Clinic/Center
  • Cass Lake, MN
  • NPI 1144353343
  NPD (past)
• Michael a Rowley MD PA

  • Diagnostic Radiology Physician
  • Clovis, NM
  • NPI 1174716781
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1659402964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 1265",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802560001",
            "telephone_number": "866-898-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5637 MARINE PKWY",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524316",
            "telephone_number": "727-848-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLES",
        "first_name": "MARK",
        "middle_name": "BENEDICT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95004120",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2026672",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "RN-165625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255456900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "995N5PO",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59031735",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candida Placencia I
• Tashyana Plantilla, DC
• Playgenics Therapy Services LLC
• Kelly S Plouffe, LMFT, CCTP
• Vilaine Policarpe
• Gregory B Pollock
• Ryan Joseph Polselli, M.D.
• Rachel M Poole
• Kim Poon, RDH
• Paul Stephen Popalis, OT

• Family Nurse Practitioner in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; 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.