Individual provider Active NPI

Peter John Polski, D.C.

  • Chiropractor
  • Honolulu, HI
National Provider Identifier
1679805352
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1453 Issued in HI
Practice address
3071 Ukiuki PL
Honolulu, HI 96819-3055
Phone
(808) 675-6315
NPI assigned
Feb 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1453 HI Primary

Addresses

Primary practice location

3071 Ukiuki PL
Honolulu, HI 96819-3055

Mailing address

3071 Ukiuki PL
Honolulu, HI 96819-3055
Phone (808) 675-6315

Other identifiers 1

IdentifierTypeStateIssuer
1861231680OtherHIADDING INDIVIDUAL PROVIDER TO BUSINESS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1453HIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Peter Polski, DC, LLC Chiropractor CurrentSince Jun 9, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1679805352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 UKIUKI PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968193055",
            "telephone_number": "808-675-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 UKIUKI PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968193055",
            "telephone_number": "808-675-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSKI",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-05",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "1453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADDING INDIVIDUAL PROVIDER TO BUSINESS",
            "identifier": "1861231680",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.