Individual provider Active NPI

Marc A Polacco, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • North Liberty, IA
National Provider Identifier
1689084022
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
MD-49974 Issued in IA
Practice address
1750 Jordan St
North Liberty, IA 52317-8089
Phone
(319) 569-3444
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD-49974 IA
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X MD-49974 IA Primary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 49974 GA

Addresses

Primary practice location

1750 Jordan St
North Liberty, IA 52317-8089

Mailing address

1750 Jordan St
North Liberty, IA 52317-8089
Phone (319) 569-3444

Other practice location 1

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2177

Other practice location 2

500 E Market St
Iowa City, IA 52245-2633
Phone (319) 339-3551

Other practice location 3

105 E 9th St
Coralville, IA 52241-2209
Phone (319) 467-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241107001085 WI Practitioner - Otolaryngology 0345539748 Reassigns benefits to 3 organizations
I20260325002942 IA Practitioner - Otolaryngology 0345539748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Iowa, RJ & L Carver College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

Hospital & facility affiliations

  • University of Iowa Hospital & Clinics Hospital, Iowa City, IA, CCN 160058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49974GAMDOtolaryngology/Facial Plastic Surgery Physician
MD-49974IAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Nov 25, 2024 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Nov 25, 2024 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Nov 25, 2024 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Feb 1, 2025 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Feb 1, 2025 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Nov 25, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

2311 N Prospect Ave
Milwaukee, WI 53211
Phone (414) 319-3000

2251 N Shore Dr
Rhinelander, WI 54501
Phone (715) 361-2300

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

824 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Interoperability endpoints

  • Direct secure messaging: mpolacco349239@direct.aspirus.org

Organizations & group practices 8

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": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1689084022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178089",
            "telephone_number": "319-569-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178089",
            "telephone_number": "319-569-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-2177",
            "fax_number": "319-356-4547",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 E Market St",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522452633",
            "country_code": "US",
            "telephone_number": "319-339-3551",
            "fax_number": "319-248-7945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 E 9th St",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412209",
            "country_code": "US",
            "telephone_number": "319-467-2000",
            "fax_number": "319-356-3949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLACCO",
        "first_name": "MARC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "MD-49974",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IA",
            "license": "MD-49974",
            "primary": true
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "GA",
            "license": "49974",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.