Individual provider Active NPI

Michael Alan Polich, N.P.

  • Family Nurse Practitioner
  • Dyer, IN
National Provider Identifier
1871675637
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71001158A Issued in IN
Practice address
1532 Calumet Ave
Dyer, IN 46311-1588
Phone
(872) 231-3162
NPI assigned
Oct 20, 2006
Last updated
Oct 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71001158A IN Primary

Addresses

Primary practice location

1532 Calumet Ave
Dyer, IN 46311-1588

Mailing address

PO Box 74008272
Chicago, IL 60674-8272
Phone (702) 899-0595

Other identifiers 1

IdentifierTypeStateIssuer
200324200MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL, VT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050606000473 IN Practitioner - Nurse Practitioner 4284677824 Reassigns benefits to 5 organizations
I20071226000327 IL Practitioner - Nurse Practitioner 4284677824 Reassigns benefits to 5 organizations
I20250623002834 VT Practitioner - Nurse Practitioner 4284677824 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infectious Disease Specialists PCGroup PAC ID 4981691862, 12 clinicians
Daniel Funsch Jr MD PCGroup PAC ID 1951801836, 139 clinicians
Ivy Medical Group PLLCGroup PAC ID 4981097797, 120 clinicians
RP Wellness Center MD IncGroup PAC ID 6800116146, 2 clinicians
Dr Rebman Medical PAGroup PAC ID 3678087400, 88 clinicians

Practice addresses (Care Compare)

2701 Leonard Dr
Suite B
Valparaiso, IN 46383-7121
Phone (219) 972-1547

350 W Schaumburg Rd
Suite 2
Schaumburg, IL 60194-3400
Phone (212) 734-6621

5490 Broadway
Suite 106
Merrillville, IN 46410-1676
Phone (219) 939-7130

596 Sheldon Rd
Saint Albans, VT 05478-8011
Phone (212) 734-6621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.1 of 100Reported as group
Quality
70.56
Improvement activities
40
Cost
72.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001158AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical LLC Family CurrentSince Sep 27, 2023 Accepting new patients
Dr Rebman BH LLC CurrentSince Dec 25, 2025 Accepting new patients
Infectious Disease Specialists PC CurrentSince May 1, 2009 Accepting new patients
Integrated Rehab Consultants LLC CurrentSince May 30, 2025 Accepting new patients
Integrated Rehab Consultants LLC CurrentSince May 30, 2025 Accepting new patients
Dr Rebman Medical PA CurrentSince Dec 13, 2025 Accepting new patients
Ivy Medical Group PLLC CurrentSince Mar 2, 2025 Accepting new patients
American Association of Visiting Physicians Past Accepting new patients
Highland Clinic of Northwest Indiana Inc PastSince Sep 8, 2014 Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients

Locations

1333 Burr Ridge Pkwy
Ste 200
Burr Ridge, IL 60527
Phone (630) 308-8706

350 W Schaumburg Rd
Ste 2
Schaumburg, IL 60194

45 Beachway Dr
Indianapolis, IN 46224
Phone (317) 241-0577

200 E 86th Pl
Merrillville, IN 46410
Phone (219) 649-2750

2400 Silhavy Rd
Valparaiso, IN 46383
Phone (219) 462-1778

2701 Leonard Dr
#A
Valparaiso, IN 46383
Phone (219) 464-9800

2701 Leonard Dr
#B
Valparaiso, IN 46383
Phone (219) 464-9800

885 3rd Ave
Fl 28
New York, NY 10022
Phone (929) 650-3990

596 Sheldon Rd
Saint Albans, VT 05478
Phone (802) 524-6534

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1871675637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74008272",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606748272",
            "telephone_number": "702-899-0595",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 CALUMET AVE",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111588",
            "telephone_number": "872-231-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICH",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001158A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200324200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

Verify at the official NPI Registry.