Thomas M Polovitz, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4117 Issued in ND

Practice address

722 NW 7TH St
Brainerd, MN 56401-2912

Phone

(218) 855-1115

Fax

(218) 855-1183

NPI assigned

Sep 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1871685206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 NW 7TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012912",
            "telephone_number": "218-855-1115",
            "fax_number": "218-855-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 NW 7TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012912",
            "telephone_number": "218-855-1115",
            "fax_number": "218-855-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLOVITZ",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "4117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aby Zachariah Philip, MBBS
• Rebecca Ann Piekarski, PHARMD
• Cassie A Piepkorn, APRN,CNP
• Deanne Marie Pikula
• Angela Pitan
• Stuart James Popkin, L.I.C.S.W.
• Jeffrey Sam Porter, MD
• Minto K Porter, MD
• Robert O Posch, M.D.
• Private Healthcare Facilities

• Family Medicine Physician in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.