Madison Polen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501020243 Issued in MI

Practice address

2807 Lake Michigan Dr NW Ste 1
Grand Rapids, MI 49504-5831

Phone

(616) 828-1326

Fax

(616) 228-9578

NPI assigned

Sep 7, 2021

Last updated

Sep 7, 2021By 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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.48 of 100Reported as group

Quality

74.96

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

86.32 of 100Reported as group

Quality

84.44

Promoting interoperability

99

Improvement activities

40

Cost

70.78

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: madison.polen.p4@direct.athleticoltd.nextgenshare.com

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.

• Athletico LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028

  MI

  Medicare reassignment Care Compare group NPD
• Foot & Ankle Specialists of West Michigan P L L C

  • Primary Podiatric Medicine Podiatrist
  • Grand Rapids, MI
  • NPI 1154460962
  Medicare reassignment NPD
• Foot & Ankle Specialists of West Michigan P L L C

  • Foot & Ankle Surgery Podiatrist
  • Carson City, MI
  • NPI 1639907165
  NPD
• Athletico LTD

  dba Athletico Physical Therapy

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1912676677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 LAKE MICHIGAN DR NW STE 1",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045831",
            "telephone_number": "616-828-1326",
            "fax_number": "616-228-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEN",
        "first_name": "MADISON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501020243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karly Aaron Polash
• Erika Lyn Polaski, DIPLOMA
• Latha Sree Polavaram, MD
• Anthony Polazzo
• James Robert Polega, MD
• Victoria A Poleni, MSW
• Jennifer Marie Poling, LMSW
• Carolyn Polinice
• Kathy Polise
• Joanna M Polizzi, PA-C

• Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.