Individual provider Active NPI

Kate Polyak, PA

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1760141436
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027931 Issued in NY
Practice address
222 Alexander St Ste 1100
Rochester, NY 14607-4005
Phone
(585) 922-8585
Fax
(585) 922-8555
NPI assigned
Dec 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 027931 NY Primary

Addresses

Primary practice location

222 Alexander St Ste 1100
Rochester, NY 14607-4005

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-8585

Other practice location 1

1415 Portland Ave Ste 400
Rochester, NY 14621-3022
Phone (585) 922-4200

Other practice location 2

1250 Driving Park Ave
Newark, NY 14513-1057
Phone (315) 332-2427

Other practice location 3

309 Upper Falls Blvd
Rochester, NY 14605-2105
Phone (585) 922-0260

Other practice location 4

2000 Empire Blvd Ste 200
Webster, NY 14580-1957
Phone (585) 922-0374

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220322001213 NY Practitioner - Physician Assistant 1052706439 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of Ny Upstate Medical University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesee Valley Obstetrics and Gynecology PCGroup PAC ID 1951326719, 7 clinicians

Practice addresses (Care Compare)

21 Willow Pond Way
Suite 100
Penfield, NY 14526-2687
Phone (585) 641-0399

990 S Ave
Suite 200
Rochester, NY 14620-2740
Phone (585) 232-3210

Hospital & facility affiliations

  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027931NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Feb 2, 2022 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Feb 2, 2022 Accepting new patients
Western New York Medical Practice P.C CurrentSince Feb 2, 2022 Accepting new patients
Rochester General Hospital CurrentSince Feb 2, 2022 Accepting new patients

Locations

1250 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2427

43 Willow Pond Way
Ste 200
Penfield, NY 14526
Phone (585) 377-5420

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

222 Alexander St
Ste 1100
Rochester, NY 14607
Phone (585) 922-8585

1415 Portland Ave
Ste 400
Rochester, NY 14621
Phone (585) 922-4200

309 Upper Falls Blvd
Rochester, NY 14605
Phone (585) 922-0260

2000 Empire Blvd
Ste 200
Webster, NY 14580
Phone (585) 671-0860

Interoperability endpoints

  • Direct secure messaging: katepolyakpa@gvogobgyn.medentdirect.com

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 2

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": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1760141436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-8585",
            "fax_number": "585-922-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ALEXANDER ST STE 1100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146074005",
            "telephone_number": "585-922-8585",
            "fax_number": "585-922-8555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Portland Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213022",
            "country_code": "US",
            "telephone_number": "585-922-4200",
            "fax_number": "585-922-4922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 Driving Park Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NY",
            "postal_code": "145131057",
            "country_code": "US",
            "telephone_number": "315-332-2427",
            "fax_number": "315-332-2324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Upper Falls Blvd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146052105",
            "country_code": "US",
            "telephone_number": "585-922-0260",
            "fax_number": "585-922-0245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Empire Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "NY",
            "postal_code": "145801957",
            "country_code": "US",
            "telephone_number": "585-922-0374",
            "fax_number": "585-797-2533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLYAK",
        "first_name": "KATE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.