Individual provider Active NPI

Polina Goldenberg

  • Obstetrics & Gynecology Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1720516974
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
CNM04179 Issued in FL
Practice address
1000 NW 9TH CT Ste 103
Boca Raton, FL 33486-2268
Phone
(561) 338-9811
NPI assigned
Jun 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X APRN9377813 FL
Obstetrics & Gynecology Nurse Practitioner 363LX0001X CNM04179 FL Primary

Addresses

Primary practice location

1000 NW 9TH CT Ste 103
Boca Raton, FL 33486-2268

Mailing address

1000 NW 9TH CT Ste 103
Boca Raton, FL 33486-2268
Phone (561) 338-9811

Other identifiers 1

IdentifierTypeStateIssuer
1871572032OtherGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210511003056 FL Practitioner - Certified Nurse Midwife (CNM) 4789093352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mira Womens Health and MidwiferyGroup PAC ID 5890235519, 10 clinicians

Practice addresses (Care Compare)

1601 Clint Moore Rd
Suite 210
Boca Raton, FL 33487-5716
Phone (561) 488-1801

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
84.84
Promoting interoperability
100
Improvement activities
40
Cost
77.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
CNM04179FLMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mira Women'S Health and Midwifery CurrentSince Aug 16, 2024 Accepting new patients
OB Hospitalist Group LLC CurrentSince Jul 8, 2024 Accepting new patients
OB Hospitalist Group LLC CurrentSince Jul 8, 2024 Accepting new patients
OB Hospitalist Group LLC Current Accepting new patients
Feinerman Anesthesia PA Past Accepting new patients
Vitalmd Group Holding LLC PastSince Jul 3, 2019 Accepting new patients

Locations

660 Glades Rd
Ste 340
Boca Raton, FL 33431
Phone (561) 392-7508

800 Meadows Rd
Boca Raton, FL 33486
Phone (561) 395-7100

1000 NW 9th Ct
Ste 103
Boca Raton, FL 33486
Phone (561) 221-2236

1601 Clint Moore Rd
Ste 210
Boca Raton, FL 33487
Phone (561) 488-1801

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 6

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": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1720516974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NW 9TH CT STE 103",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862268",
            "telephone_number": "561-338-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NW 9TH CT STE 103",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862268",
            "telephone_number": "561-338-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "POLINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "APRN9377813",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "CNM04179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1871572032",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.