NPIMap

Individual provider Active NPI

Daniel Benjamin Poliak, M.D.

  • Diagnostic Radiology Physician
  • Bethlehem, PA
National Provider Identifier
1679967897
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD471300 Issued in PA
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(484) 526-4000
NPI assigned
Mar 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X MD471300 PA Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

95 Highland Ave Ste 130
Bethlehem, PA 18017-9483
Phone (610) 868-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Sluhn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210520001056 PA Practitioner - Diagnostic Radiology 6800295023 Reassigns benefits to 1 organization
I20210520001178 NJ Practitioner - Diagnostic Radiology 6800295023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Physician Assoc IncGroup PAC ID 1355243809, 164 clinicians

Practice addresses (Care Compare)

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (908) 859-6700

801 Ostrm St
Bethlehem, PA 18015-1000
Phone (610) 868-1100

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057
  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035
  • St Luke'S Hospital - Carbon Campus Hospital, Lehighton, PA, CCN 390335
  • St Luke'S Hospital - Monroe Campus Hospital, Stroudsburg, PA, CCN 390330

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD471300PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Physician Assoc Inc Diagnostic Radiology CurrentSince May 6, 2021 Accepting new patients
Progressive Physician Assoc, Inc. Diagnostic Radiology PastSince Jun 21, 2022 Accepting new patients

Locations

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

95 Highland Ave
Ste 130
Bethlehem, PA 18017
Phone 61086811002

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 2

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 10

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1679967897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 HIGHLAND AVE STE 130",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179483",
            "telephone_number": "610-868-1100",
            "fax_number": "610-868-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIAK",
        "first_name": "DANIEL",
        "middle_name": "BENJAMIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD471300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Sluhn.org",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "801 Ostrum St",
            "city": "Bethlehem",
            "state": "PA",
            "country_code": "US",
            "postal_code": "180151000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.