Active NPI
Jillian A. Polonchak, AGACNP-BC
- Critical Care Medicine (Anesthesiology) Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Anesthesiology) Physician
- License
- R256994
- Practice address
- 1520 San Pablo St Ste 3000
Los Angeles, CA 90033-5315 - Phone
- (323) 442-5710
- NPI assigned
- Sep 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | NP95012773 | CA | |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | R256994 | MD | Primary |
Addresses
Primary practice location
1520 San Pablo St Ste 3000
Los Angeles, CA 90033-5315
Mailing address
6201 Greenleigh Ave FL 2
Middle River, MD 21220-2004
Phone (410) 933-2704
Other practice location 1
1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 955-8893
Other names 1
- Jill A. Schimke
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jillian.polonchak@direct.usc.edu | Direct | USC CARE MEDICAL GROUP, INC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000
600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340
6201 Greenleigh Ave
Middle River, MD 21220-2004
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R256994 | MD | MD | Critical Care Medicine (Anesthesiology) Physician |
| NP95012773 | CA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johns Hopkins University | Current | Accepting new patients | |
| Johns Hopkins University | Critical Care Medicine | Current | Accepting new patients |
| Johns Hopkins University | Current | Accepting new patients | |
| Usc Care Medical Group, Inc | Current | Accepting new patients | |
| Usc Care Medical Group, Inc | Current | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
1520 San Pablo St
Ste 3000
Los Angeles, CA 90033
Phone (323) 442-5728
1540 Alcazar St
Ste 215
Los Angeles, CA 90089
Phone (323) 442-7686
1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849
15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051
600 N Wolfe St
Baltimore, MD 21287
1800 Orleans St
Baltimore, MD 21287
Phone (410) 502-2037
6201 Greenleigh Ave
Fl 2
Middle River, MD 21220
Phone (410) 933-2704
6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704
Interoperability endpoints
- jpolonchak1036825@direct.hopkinsmedicine.org
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.
-
- Pain Medicine (Anesthesiology) Physician
- Baltimore, MD
- NPI 1922008549
-
- General Practice Physician
- Los Angeles, CA
- NPI 1902846306
-
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
- NPI 1427937390
-
- Ophthalmology Physician
- Belcamp, MD
- NPI 1376342774
-
- Critical Care Medicine (Anesthesiology) Physician
- Baltimore, MD
- NPI 1881694453
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Baltimore, MD
- NPI 1578597993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729728000000",
"number": "1942850888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6201 GREENLEIGH AVE FL 2",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212202004",
"telephone_number": "410-933-2704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 SAN PABLO ST STE 3000",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335315",
"telephone_number": "323-442-5710"
}
],
"practiceLocations": [
{
"address_1": "1800 Orleans St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212870010",
"country_code": "US",
"telephone_number": "410-955-8893",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLONCHAK",
"first_name": "JILLIAN",
"middle_name": "A.",
"credential": "AGACNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-12",
"last_updated": "2024-10-24",
"certification_date": "2024-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "CA",
"license": "NP95012773",
"primary": false
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "MD",
"license": "R256994",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jillian.polonchak@direct.usc.edu",
"affiliation": "Y",
"affiliationName": "USC CARE MEDICAL GROUP, INC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1520 San Pablo St Ste 3000",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900335315",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JILL",
"last_name": "SCHIMKE",
"middle_name": "A.",
"credential": "AGACNP-BC",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.