Active NPI
Mark J Polisar, MD
- Family Medicine Physician
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 215837
- Practice address
- MMG - Williamsbridge
3448 Boston Road
Bronx, NY 10469 - Phone
- (718) 547-6111
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 215837 | NY | Primary |
Addresses
Primary practice location
MMG - Williamsbridge
3448 Boston Road
Bronx, NY 10469
Mailing address
26 Sycamore LN
Irvington, NY 10533-1918
Phone (718) 547-6111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Albert Einstein College of Medicine of Yeshiva University, 1988
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255
Hospital & facility affiliations
- Montefiore Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215837 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current | Accepting new patients |
Locations
3011 Boston Rd
Bronx, NY 10469
Phone (718) 547-6111
111 E 210th St
Bronx, NY 10467
360 E 193rd St
Bronx, NY 10458
Phone (718) 405-4067
3448 Boston Rd
Bronx, NY 10469
Phone (718) 547-6111
1055 E Tremont Ave
Bronx, NY 10460
Phone (718) 842-8040
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- mpolisar@montefioredirect.com
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.
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1063525152
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1952476988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700956992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 SYCAMORE LN",
"city": "IRVINGTON",
"state": "NY",
"postal_code": "105331918",
"telephone_number": "718-547-6111",
"fax_number": "718-547-4749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MMG - WILLIAMSBRIDGE",
"address_2": "3448 BOSTON ROAD",
"city": "BRONX",
"state": "NY",
"postal_code": "10469",
"telephone_number": "718-547-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLISAR",
"first_name": "MARK",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "215837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.