Active NPI
Brandon Polking
- Physical Therapist
- Cincinnati, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT016964
- Practice address
- 5500 Harrison Ave
Cincinnati, OH 45248-2361 - Phone
- (513) 661-3114
- NPI assigned
- Jun 12, 2017
- Last updated
- Jun 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT016964 | OH | Primary |
Addresses
Primary practice location
5500 Harrison Ave
Cincinnati, OH 45248-2361
Mailing address
3761 Herbert Ave
Cincinnati, OH 45211-5436
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6173 D Glenway Ave
Cincinnati, OH 45211-6312
Phone (513) 250-4990
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.32 of 100
- Quality
- 84.44
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT016964 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
Locations
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
6173 Glenway Ave
Unit D
Cincinnati, OH 45211
Phone (513) 250-4990
4925 Jackman Rd
Ste 34
Toledo, OH 43613
Phone (567) 318-1000
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.
-
dba Athletico Physical Therapy
- Clinic/Center
- Lafayette, IN
- NPI 1053044867
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497225600000",
"number": "1801326947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3761 HERBERT AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452115436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 HARRISON AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452482361",
"telephone_number": "513-661-3114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLKING",
"first_name": "BRANDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-12",
"last_updated": "2017-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT016964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.