Michele Polidoro, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

200800806 Issued in NC

Practice address

584 Hospital Dr NE Unit B
Bolivia, NC 28422-0020

Phone

(910) 721-4050

Fax

(910) 721-4051

NPI assigned

Mar 14, 2006

Last updated

Aug 19, 2024By 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 18

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Obstetrics/Gynecology

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpolidoro540212@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Outer Banks Professional Services, LLC

  dba Outer Banks Hospital Urgent Care

  • Multi-Specialty Clinic/Center
  • Nags Head, NC
  • NPI 1891050357

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Novant Health Medical Group LLC

  dba NHMG OBGYN Clinics

  • Obstetrics & Gynecology Physician
  • Huntersville, NC
  • NPI 1477276699
  NPD
• Wilkes Physician Network, Inc.

  dba Wilkes Regional Family Medicine

  • Family Medicine Physician
  • North Wilkesboro, NC
  • NPI 1245496413
  NPD
• Benion S. Horton, MD, PC

  dba Northwest Carolina Women's Center

  • Obstetrics & Gynecology Physician
  • North Wilkesboro, NC
  • NPI 1235316274
  NPD (past)
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)
• Kiran Trivedi DO PLLC

  • Obstetrics & Gynecology Physician
  • Islip, NY
  • NPI 1205016110
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1780652909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "910-721-4050",
            "fax_number": "910-721-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 HOSPITAL DR NE UNIT B",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284220020",
            "telephone_number": "910-721-4050",
            "fax_number": "910-721-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 W Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "NC",
            "postal_code": "272926773",
            "country_code": "US",
            "telephone_number": "336-243-7054",
            "fax_number": "336-243-2302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLIDORO",
        "first_name": "MICHELE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "200800806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCAL 1199",
            "identifier": "113510097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "200921",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN, INDIVIDUAL FOR WILKES",
            "identifier": "2022373A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "10119",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "1049966",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IEC BENEFIT ADMINISTRATOR",
            "identifier": "113510097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ISLAND GROUP ADMINISTRATO",
            "identifier": "113510097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "113510097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "33D0967171",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MALPRACTICE POLICY",
            "identifier": "MP0427139",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AARP",
            "identifier": "113510097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "2504",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGNACARE",
            "identifier": "113510097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "6431110003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AA01072",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "38H991",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA SENIOR",
            "identifier": "6431110006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IVR ACC CODE",
            "identifier": "910931",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpolidoro540212@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "108 W Medical Park Dr",
            "city": "Lexington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272926773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brian Yongjin Pak
• James Bryant Pate, APRN
• Cayce McCall Patterson
• Annemarie Petty, OTR/L
• Debbora Kay Pittman, LCMHC
• Katherine Kelly Poole, LCSW-A
• Brandi Posey, M.S. CCC-SLP
• James Rosser Powell, MD
• Prentice Counseling & Associates, PLLC
• Ty Prentice, MA, NCC

• Obstetrics & Gynecology Physician in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.