Individual provider Active NPI

Michael Henry Polcino, MD

  • Surgery Physician
  • West Babylon, NY
National Provider Identifier
1932475308
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
254871 Issued in NY
Practice address
141 Little East Neck Rd
West Babylon, NY 11704-7719
Phone
(631) 482-8134
Fax
(631) 647-5949
NPI assigned
Mar 29, 2012
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
Surgery Physician 208600000X 254871 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) 482-8134

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
I20150220000661 NY Practitioner - Colorectal Surgery (Proctology) 0648595355 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Icahn School of Medicine at Mount Sinai, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SBH Physicians PCGroup PAC ID 3072798941, 178 clinicians

Practice addresses (Care Compare)

141 Little E Neck Rd
West Babylon, NY 11704-7719
Phone (631) 482-8134

4422 3Rd Ave
Bronx, NY 10457-2545
Phone (718) 960-6214

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254871NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC CurrentSince Jul 22, 2017 Accepting new patients
SBH Physicians, PC Surgery CurrentSince Jul 22, 2017 Accepting new patients
Michael H Polcino, MD, PLLC CurrentSince Aug 11, 2014 Accepting new patients
Michael Polcino MD PC CurrentSince Jun 27, 2021 Accepting new patients
St. Barnabas Hospital Past Accepting new patients

Locations

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

4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

2016 Bronxdale Ave
Ste 202
Bronx, NY 10462
Phone (203) 856-8550

4507 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

111 E 210th St
Bronx, NY 10467

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: mpolcino19565@sbhny.direct-ci.net
  • Direct secure messaging: michael.polcino.1@16505.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/16505/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 8

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1932475308",
    "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": "631-482-8134",
            "fax_number": "631-647-5949"
        },
        {
            "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": "631-482-8134",
            "fax_number": "631-647-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLCINO",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "254871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

Verify at the official NPI Registry.