NPIMap

Individual provider Active NPI

Jose F Polanco, M.D., P.A.

  • Internal Medicine Physician
  • Bradenton, FL
National Provider Identifier
1750346086
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
593599123 Issued in FL
Practice address
311 3Rd Ave E
Bradenton, FL 34208-1014
Phone
(941) 708-3358
Fax
(941) 749-1046
NPI assigned
Apr 19, 2006
Last updated
Aug 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 593599123 FL Primary

Addresses

Primary practice location

311 3Rd Ave E
Bradenton, FL 34208-1014

Mailing address

311 3Rd Ave E
Bradenton, FL 34208-1014
Phone (941) 708-3358

Other identifiers 4

IdentifierTypeStateIssuer
322675OtherFLAETNA
003131900MedicaidFL
110194124OtherFLRAILROAD MC
41923OtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081119000541 FL Practitioner - Internal Medicine 8820158991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

11661 State Rd 70
Lakewood Ranch, FL 34202-9416
Phone (941) 222-0321

311 3Rd Ave E
Bradenton, FL 34208-1014
Phone (941) 708-3358

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jose F Polanco MD PA Internal Medicine CurrentSince Oct 29, 2008 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

311 3rd Ave E
Bradenton, FL 34208
Phone (941) 708-3358

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAGDBA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1750346086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 3RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081014",
            "telephone_number": "941-708-3358",
            "fax_number": "941-749-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 3RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081014",
            "telephone_number": "941-708-3358",
            "fax_number": "941-749-1046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "JOSE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "593599123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "322675",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003131900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC",
            "identifier": "110194124",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "41923",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.