Leticia A. Polanco, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A76528 Issued in CA

Practice address

525 3Rd Ave
Chula Vista, CA 91910-5616

Phone

(858) 499-2600

Fax

(619) 585-4390

NPI assigned

Mar 14, 2006

Last updated

Feb 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

Boston University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ciecal RC IncGroup PAC ID 0446539241, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lorian Health Home health agency, San Diego, CA, CCN 058113
• Sharp Chula Vista Medical Center Hospital, Chula Vista, CA, CCN 050222
• Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ciecal RC Inc

  dba South Bay Primary Medical Group

  • Primary Care Clinic/Center
  • Chula Vista, CA
  • NPI 1942659149
  Medicare reassignment Care Compare group NPD
• Sharp Chula Vista Medical Center

  dba Birch Patrick Convalescent Center

  • Skilled Nursing Facility
  • Chula Vista, CA
  • NPI 1538142369
  NPD (past)
• Shoreline Medical Group Professional Corporation

  • Family Medicine Physician
  • Chula Vista, CA
  • NPI 1225860232
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grossmont Hospital Corporation

  dba Sharp Grossmont Hospital

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation
• Lorian Home Systems, Inc.

  dba Lorian Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1447318092
  Care Compare affiliation
• Sharp Chula Vista Medical Center

  • General Acute Care Hospital
  • Chula Vista, CA
  • NPI 1396728630
  Care Compare affiliation
• Sharp Memorial Hospital

  dba Sharp Allison deRose Rehabilitation Center

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  Care Compare affiliation
• Sharp Memorial Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1407839921
  Care Compare affiliation

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1710956818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 MEDICAL CENTER CT",
            "address_2": "STE 303",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116602",
            "telephone_number": "858-499-2600",
            "fax_number": "619-585-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 3RD AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105616",
            "telephone_number": "858-499-2600",
            "fax_number": "619-585-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "LETICIA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A765280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stanley Roy Plucinik, OD
• Jacob S Plum
• Ana Valeria Poggio, D.D.S.
• Ashunty Alise Pointe
• Paloma Anais Polanco Figueroa
• Tracy L. Polanco, M.D.
• Shannon Polley
• Rebecca Ines Ponce
• Sara R Ponce, FNP-BC
• Sonia Gabriela Ponce, MD

• Family Medicine Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.

Verify at the official NPI Registry.