Maryanna Polukhin, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

034968 Issued in CT

Practice address

18 Cedar St
Grove Hill Medical Center
Newington, CT 06111-2647

Phone

(860) 666-5252

Fax

(860) 666-5153

NPI assigned

Sep 2, 2005

Last updated

Jul 9, 2007By 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

Other identifiers 10

Other names 1

• Dr. Maryanna Gozun Former name

Medicare fee-for-service enrollment

Enrolled in CT

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

Internal Medicine

Education

Johns Hopkins University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Starling Physicians, PLLCGroup PAC ID 7517863749, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
• American Home Health, Inc Home health agency, West Hartford, CT, CCN 077250
• The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035
• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maryanna.polukhin@xdr.hhchealthdirect.org

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.

• Starling Physicians, PLLC

  • Internal Medicine Physician
  • Rocky Hill, CT
  • NPI 1467537290
  Medicare reassignment Care Compare group NPD
• Starling Physicians PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomfield, CT
  • NPI 1760355861
  NPD
• Starling Physicians, PLLC

  dba Starling Physicians PC

  • Mammography Clinic/Center
  • New Britain, CT
  • NPI 1720182991
  NPD (past)

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

• American Home Health, Inc

  • Home Health Agency
  • West Hartford, CT
  • NPI 1801059134
  Care Compare affiliation
• Hartford Healthcare at Home, Inc

  • Home Health Agency
  • Wethersfield, CT
  • NPI 1073529566
  Care Compare affiliation
• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation
• New Britain General Hospital

  • General Acute Care Hospital
  • New Britain, CT
  • NPI 1548225360
  Care Compare affiliation
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • General Acute Care Hospital
  • New Britain, CT
  • NPI 1053477075
  Care Compare affiliation

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1881688034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KENSINGTON AVE",
            "address_2": "GROVE HILL MEDICAL CENTER",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060513916",
            "telephone_number": "860-666-5252",
            "fax_number": "860-666-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CEDAR ST",
            "address_2": "GROVE HILL MEDICAL CENTER",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112647",
            "telephone_number": "860-666-5252",
            "fax_number": "860-666-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLUKHIN",
        "first_name": "MARYANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "034968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001349689",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHMC GROUP NPI ID",
            "identifier": "1255448155",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5247130",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P369816",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "060118",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110182439",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "349680",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004215324",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS & BCFP PROV ID",
            "identifier": "010034968CT04",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "01034968",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYANNA",
            "last_name": "GOZUN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Pizzitola, DO
• Christina A Plantier, PA-C
• Lauren Diane Plass, O.D
• Ellie Plukas Smith, R.N. , APRN, BC
• Cora Sophie Pokrifka, M.S. CCC-SLP
• Erika Polyanskaya, MD
• Devin Patrick Pray, NP-C
• Premier Healthcare Services of Connecticut LLC (Premier Urgent Care)
• Jessica Prisco, NP
• Professional Nurse Practitioner

• Internal Medicine Physician in Newington, CT
• Providers in Newington, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.