Individual provider Active NPI

Kathryn McCann Polcaro, PA

  • Physician Assistant
  • Rockville, MD
National Provider Identifier
1952540957
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002971 Issued in VA
Practice address
9715 Medical Center Dr
Suite 415
Rockville, MD 20850-3320
Phone
(301) 340-9200
Fax
(301) 279-9358
NPI assigned
Feb 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002971 VA Primary

Addresses

Primary practice location

9715 Medical Center Dr
Suite 415
Rockville, MD 20850-3320

Mailing address

9715 Medical Center Dr
Suite 415
Rockville, MD 20850-3320
Phone (301) 340-9200

Other identifiers 1

IdentifierTypeStateIssuer
1952540957MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000149 DC Practitioner - Physician Assistant 5597813352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Physician Services IncGroup PAC ID 4284631540, 144 clinicians

Practice addresses (Care Compare)

9901 Medical Ctr Dr
Rockville, MD 20850-3357
Phone (301) 279-6000

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
79.78
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110002971VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bethesda Chevy Chase Orthopaedic Associates, LLC CurrentSince May 17, 2022 Accepting new patients
Bethesda Chevy Chase Orthopaedic Associates, LLC CurrentSince May 17, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

10215 Fernwood Rd
Ste 506
Bethesda, MD 20817
Phone (240) 482-2414

19735 Germantown Rd
Ste 120
Germantown, MD 20874
Phone (301) 340-9200

9601 Blackwell Rd
Rockville, MD 20850
Phone (240) 428-7311

9601 Blackwell Rd
Ste 100
Rockville, MD 20850
Phone (301) 340-9200

Interoperability endpoints

  • Direct secure messaging: kathrynpolcaro@bccoallp.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1952540957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9715 MEDICAL CENTER DR",
            "address_2": "SUITE 415",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503320",
            "telephone_number": "301-340-9200",
            "fax_number": "301-279-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9715 MEDICAL CENTER DR",
            "address_2": "SUITE 415",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503320",
            "telephone_number": "301-340-9200",
            "fax_number": "301-279-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLCARO",
        "first_name": "KATHRYN",
        "middle_name": "MCCANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952540957",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.