Individual provider Active NPI

Jeremy Polman, DO

  • Gastroenterology Physician
  • New York, NY
National Provider Identifier
1659831360
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
322389 Issued in NY
Practice address
178 E 85TH St FL 4
New York, NY 10028-2119
Phone
(212) 434-3427
NPI assigned
Mar 20, 2019
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T6677 TX
Gastroenterology Physician 207RG0100X 322389 NY Primary

Addresses

Primary practice location

178 E 85TH St FL 4
New York, NY 10028-2119

Mailing address

178 E 85TH St FL 4
New York, NY 10028-2119
Phone (212) 434-3427

Other practice location 1

3401 North Blvd Ste 130
Baton Rouge, LA 70806-3743
Phone (225) 387-7900

Other practice location 2

2111 Kramer Ln Ste 100
Austin, TX 78758-4032
Phone (512) 566-4233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220716000114 TX Practitioner - Internal Medicine 9335476290 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322389NYMDLicensed Practical Nurse
T6677TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Dose Management PA Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Lonestar Pat Associates PA Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

1401 Lavaca St
Austin, TX 78701
Phone (512) 222-7411

2111 Kramer Ln
Ste 100
Austin, TX 78758
Phone (512) 508-8320

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

Interoperability endpoints

  • Direct secure messaging: jeremy.polman.1@25634.direct.athenahealth.com
  • Direct secure messaging: jpolman25989@northwell.direct-ci.com

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1659831360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 E 85TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282119",
            "telephone_number": "212-434-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 E 85TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282119",
            "telephone_number": "212-434-3427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 North Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708063743",
            "country_code": "US",
            "telephone_number": "225-387-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2111 Kramer Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787584032",
            "country_code": "US",
            "telephone_number": "512-566-4233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLMAN",
        "first_name": "JEREMY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T6677",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "322389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.