Prido Jose Polanco Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

74291 Issued in AZ

Practice address

6060 N Fountain Plaza Dr Ste 270
Tucson, AZ 85704-7873

Phone

(520) 229-2578

Fax

(520) 229-2561

NPI assigned

Apr 1, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northwest Urgent Care LLCGroup PAC ID 9830506062, 70 clinicians

Northwest Allied Physicians LLCGroup PAC ID 7618972514, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Medical Center Hospital, Tucson, AZ, CCN 030085
• Oro Valley Hospital Hospital, Oro Valley, AZ, CCN 030114

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: prido.polanco.jr.2@1576.direct.athenahealth.com
• Direct secure messaging: prido.polanco.jr.1@1576.direct.athenahealth.com

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.

• Northwest Allied Physicians LLC

  • General Practice Physician
  • Tucson, AZ
  • NPI 1003833179
  Medicare reassignment Care Compare group NPD
• Northwest Urgent Care LLC

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1528683455
  Medicare reassignment Care Compare group NPD
• Northwest Allied Physicians, LLC

  • Durable Medical Equipment & Medical Supplies
  • Oro Valley, AZ
  • NPI 1821302910
  NPD

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

• Northwest Hospital LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1487607784
  Care Compare affiliation
• Oro Valley Hospital LLC

  • General Acute Care Hospital
  • Oro Valley, AZ
  • NPI 1386697688
  Care Compare affiliation

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1841930237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 N FOUNTAIN PLAZA DR STE 270",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047873",
            "telephone_number": "520-229-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 N FOUNTAIN PLAZA DR STE 270",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047873",
            "telephone_number": "520-229-2578",
            "fax_number": "520-229-2561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6431 Fannin St Ste Jjl 3082",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "713-500-7610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "PRIDO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-01",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "74291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Poist, PHARMD
• Megan Poje, FNP-BC
• Milap Pokharel, M.D.
• Camela Alice Pokhrel, M.D.
• Dominic Polanco, LMT
• Polaris Physical Therapy P.C.
• June Polatsek, M.A.
• Dawn M. Polcyn, EDS
• Tanya Elaine Polec, OD, FCOVD
• Will Polec, NMD

• Family Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; 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.