Individual provider Active NPI

Polina Medvedeva

  • Obstetrics & Gynecology Physician
  • Elmhurst, NY
National Provider Identifier
1902288798
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
298999 Issued in NY
Practice address
8831 55TH Ave Ste 201
Elmhurst, NY 11373-4686
Phone
(718) 899-6600
Fax
(718) 606-3881
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 298999 NY Primary

Addresses

Primary practice location

8831 55TH Ave Ste 201
Elmhurst, NY 11373-4686

Mailing address

55 Water St FL 2
New York, NY 10041-0010
Phone (646) 680-2888

Other practice location 1

31-75 23rd Street
Astoria, NY 11106-4134
Phone (718) 956-2200

Other practice location 2

447 Atlantic Ave
Brooklyn, NY 11217-1702
Phone (718) 858-6300

Other practice location 3

180-05 Hillside Ave
Jamaica, NY 11432-4727
Phone (718) 526-6300

Other practice location 4

215 E 95th St Frnt 1
New York, NY 10128-4077
Phone (212) 996-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20190718002801 NY Practitioner - Obstetrics/Gynecology 1456686039 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantagecare Physicians PCGroup PAC ID 2365735008, 307 clinicians

Practice addresses (Care Compare)

88 -31
Elmhurst, NY 11373-4686
Phone (718) 899-6600

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
298999NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Jul 1, 2019 Accepting new patients
Advantagecare Physicians PC CurrentSince Mar 8, 2021 Accepting new patients
Advantagecare Physicians PC CurrentSince Mar 8, 2021 Accepting new patients
Bronxcare Health System Current Accepting new patients
Bronxcare Health System CurrentSince Jul 1, 2019 Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients

Locations

1650 Grand Concourse
Fl 5
Bronx, NY 10457
Phone (718) 239-8383

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

447 Atlantic Ave
Brooklyn, NY 11217
Phone (718) 421-2131

8831 55th Ave
#201
Elmhurst, NY 11373

8831 55th Ave
Elmhurst, NY 11373

8615 Queens Blvd
Flushing, NY 11373
Phone (917) 297-8500

18005 Hillside Ave
Jamaica, NY 11432
Phone (718) 526-6300

3175 23rd St
Long Island City, NY 11106
Phone (718) 956-2200

55 Water St
Fl 2
New York, NY 10041

215 E 95th St
Frnt 1
New York, NY 10128
Phone (212) 996-8000

215 E 95th St
New York, NY 10128
Phone (212) 423-3111

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: pmedvedeva18378@prd.direct.tbh.org
  • Direct secure messaging: pmedvedeva38670@direct.acpny.com
  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1902288798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410010",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8831 55TH AVE STE 201",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734686",
            "telephone_number": "718-899-6600",
            "fax_number": "718-606-3881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31-75 23rd Street",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111064134",
            "country_code": "US",
            "telephone_number": "718-956-2200",
            "fax_number": "718-956-2316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "447 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112171702",
            "country_code": "US",
            "telephone_number": "718-858-6300",
            "fax_number": "718-858-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180-05 Hillside Ave",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114324727",
            "country_code": "US",
            "telephone_number": "718-526-6300",
            "fax_number": "718-286-3863",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 E 95th St Frnt 1",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101284077",
            "country_code": "US",
            "telephone_number": "212-996-8000",
            "fax_number": "212-423-3904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDVEDEVA",
        "first_name": "POLINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "298999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.