Irina Y Polansky, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085002586 Issued in IL

Practice address

130 Lincoln Place CT Ste 130
Belleville, IL 62221-5884

Phone

(618) 257-1297

Fax

(618) 277-1190

NPI assigned

Jan 25, 2006

Last updated

Mar 3, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HSHS St Elizabeth's Hospital Hospital, O Fallon, IL, CCN 140187
• Red Bud Regional Hospital Hospital, Red Bud, IL, CCN 141348

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment Care Compare group
• Fairview Heights Medical Group SC

  dba BJC Medical Group of Illinois

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1073022000
  NPD
• Healthcare Physicians of Southern Illinois, PC

  • Family Medicine Physician
  • Belleville, IL
  • NPI 1023034618
  NPD (past)
• PC Associates, LLC

  • Family Medicine Physician
  • Dupo, IL
  • NPI 1437462637
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Illinois Red Bud Regional Hospital Inc

  dba Red Bud Regional Hospital

  • Critical Access Hospital
  • Red Bud, IL
  • NPI 1407573132
  Care Compare affiliation
• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  dba HSHS St. Elizabeth's Hospital

  • General Acute Care Hospital
  • O'Fallon, IL
  • NPI 1629057302
  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1801866462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LINCOLN PLACE CT STE 130",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215884",
            "telephone_number": "618-257-1297",
            "fax_number": "618-257-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LINCOLN PLACE CT STE 130",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215884",
            "telephone_number": "618-257-1297",
            "fax_number": "618-277-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANSKY",
        "first_name": "IRINA",
        "middle_name": "Y",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "130 Lincoln Place Ct Ste 130",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622215884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frank Pikul, M.D.
• Kenneth C Pinkerton, DMD
• Tracie Leigh Placher
• Plastic & Hand Surgery Associates, S.C.
• Plastic Surgery Consultants, P.C. (Plastic Surgery Consultants of Illinois)
• Jamie Marie Poorman, PT, DPT
• Angel Nicole Porter
• Kristie Lynne Porter, OTR
• Sally B Portera Mankins, MD
• Thomas Posnanski, LMFT

• Physician Assistant in Belleville, IL
• Providers in Belleville, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.