NPIMap

Individual provider Active NPI

Gregory Michael Polcha Jr., DO

  • Internal Medicine Physician
  • Youngstown, OH
National Provider Identifier
1750888103
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34.015240 Issued in OH
Practice address
1001 Covington St
Youngstown, OH 44510-1617
Phone
(330) 480-2616
Fax
(330) 480-7979
NPI assigned
Apr 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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 34.015240 OH Primary

Addresses

Primary practice location

1001 Covington St
Youngstown, OH 44510-1617

Mailing address

1001 Covington St
Youngstown, OH 44510-1617
Phone (330) 480-2616

Other practice location 1

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210707003475 OH Practitioner - Internal Medicine 4587928924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Youngstown, LLCGroup PAC ID 9234318270, 116 clinicians

Practice addresses (Care Compare)

1001 Covington St
Youngstown, OH 44510-1617
Phone (330) 746-7400

667 Eastland Ave SE
Warren, OH 44484-4503
Phone (330) 841-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown LLC CurrentSince Jul 1, 2021 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Aug 29, 2023 Accepting new patients
Mercy Health Physicians Youngstown, LLC Internal Medicine Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Aug 29, 2023 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients

Locations

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

1001 Covington St
Youngstown, OH 44510
Phone (330) 480-2616

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

1001 Covington St
Fl 2
Youngstown, OH 44510
Phone (330) 480-3033

Interoperability endpoints

  • Direct secure messaging: gpolcha420506@direct.bsmhealth.org

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.

Hospital & facility affiliations 3

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1750888103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 COVINGTON ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101617",
            "telephone_number": "330-480-2616",
            "fax_number": "330-480-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COVINGTON ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101617",
            "telephone_number": "330-480-2616",
            "fax_number": "330-480-7979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1044 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445041006",
            "country_code": "US",
            "telephone_number": "330-480-3196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLCHA",
        "first_name": "GREGORY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.015240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.