Individual provider Active NPI

Michael H Polcino, MD

  • Obstetrics & Gynecology Physician
  • West Babylon, NY
National Provider Identifier
1922180280
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
136866 Issued in NY
Practice address
141 Little East Neck Rd
West Babylon, NY 11704-7719
Phone
(631) 321-1045
Fax
(631) 321-1102
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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 136866 NY Primary

Addresses

Primary practice location

141 Little East Neck Rd
West Babylon, NY 11704-7719

Mailing address

141 Little East Neck Rd
West Babylon, NY 11704-7719
Phone (631) 321-1045

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
I20050217000636 NY Practitioner - Obstetrics/Gynecology 6103878160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York Downstate Medical Center, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

141 Little E Neck Rd
West Babylon, NY 11704-7719
Phone (631) 321-1045

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136866NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Polcino MD PC Obstetrics & Gynecology CurrentSince Jan 1, 2005 Accepting new patients
Michael H Polcino, MD, PLLC CurrentSince Jun 27, 2021 Accepting new patients

Locations

796 Deer Park Ave
North Babylon, NY 11703
Phone (631) 321-1045

141 Little East Neck Rd
West Babylon, NY 11704
Phone (631) 321-1045

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16505/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 2

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1922180280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 LITTLE EAST NECK RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117047719",
            "telephone_number": "631-321-1045",
            "fax_number": "631-321-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 LITTLE EAST NECK RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117047719",
            "telephone_number": "631-321-1045",
            "fax_number": "631-321-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLCINO",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "136866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

Verify at the official NPI Registry.