Individual provider Active NPI

Lauren Poliakin, MD

  • Surgery Physician
  • Thousand Oaks, CA
National Provider Identifier
1790162733
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2019-00765 Issued in NC
Practice address
227 W Janss Rd Ste 300
Thousand Oaks, CA 91360-1885
Phone
(805) 497-8820
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2019-00765 NC Primary

Addresses

Primary practice location

227 W Janss Rd Ste 300
Thousand Oaks, CA 91360-1885

Mailing address

227 W Janss Rd Ste 300
Thousand Oaks, CA 91360-1885

Other practice location 1

1090 Vinehaven Dr NE
Concord, NC 28025-2438
Phone (704) 403-7580

Other practice location 2

1025 Morehead Medical Dr
Suite 600
Charlotte, NC 28204-2963
Phone (704) 355-8816

Other practice location 3

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1255

Other practice location 4

10660 Park Rd
Ste 4400
Charlotte, NC 28210-8413
Phone (704) 667-2681

Other practice location 5

2630 E 7th St
Charlotte, NC 28204-4318
Phone (704) 355-9484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20201028001163 CA Practitioner - General SurgeryPractitioner - Other (Physician) 3678810637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

124 Macaw LN
Simi Valley, CA 93065-3152
Phone (805) 306-0304

2985 Sycamore Dr
Simi Valley, CA 93065-1201
Phone (805) 584-6611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)27
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren a. Poliakin, M.D., a Professional Medical Corporation Surgery CurrentSince Sep 14, 2020 Accepting new patients
Carolinas Physicians Network Inc Surgery CurrentSince Jul 29, 2019 Accepting new patients
Adventist Health Physicians Network CurrentSince Jul 1, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center CurrentSince Jul 29, 2019 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 29, 2019 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Jul 29, 2019 Accepting new patients
Adventist Health Physicians Network CurrentSince Jul 1, 2022 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients
Hanford Community Hospital Past Accepting new patients

Locations

2750 Sycamore Dr
Ste 210
Simi Valley, CA 93065
Phone (805) 520-2663

124 Macaw Ln
Simi Valley, CA 93065
Phone (805) 306-0304

227 W Janss Rd
Ste 300
Thousand Oaks, CA 91360
Phone (805) 497-7815

10660 Park Rd
Ste 4400
Charlotte, NC 28210
Phone (704) 331-9669

2630 E 7th St
Ste 100
Charlotte, NC 28204
Phone (704) 355-9484

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1025 Morehead Medical Dr
Ste 600
Charlotte, NC 28204
Phone (704) 355-4062

2630 E 7th St
Charlotte, NC 28204
Phone (704) 355-9484

2608 E 7th St
Charlotte, NC 28204
Phone (704) 344-9034

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1090 Vinehaven Dr NE
Concord, NC 28025
Phone (704) 403-7580

Organizations & group practices 13

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.

View all 13

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": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1790162733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 W JANSS RD STE 300",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W JANSS RD STE 300",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601885",
            "telephone_number": "805-497-8820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1090 Vinehaven Dr NE",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252438",
            "country_code": "US",
            "telephone_number": "704-403-7580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-355-8816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10660 Park Rd",
            "address_2": "Ste 4400",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108413",
            "country_code": "US",
            "telephone_number": "704-667-2681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2630 E 7th St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282044318",
            "country_code": "US",
            "telephone_number": "704-355-9484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLIAKIN",
        "first_name": "LAUREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2019-00765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.