Individual provider Active NPI

Polina Feygin, M.D.

  • Pediatrics Physician
  • Rancho Palos Verdes, CA
National Provider Identifier
1962569616
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G67378 Issued in CA
Practice address
30822 Via Rivera
Rancho Palos Verdes, CA 90275-5343
Phone
(310) 619-9528
Fax
(310) 206-0209
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G67378 CA Primary

Addresses

Primary practice location

30822 Via Rivera
Rancho Palos Verdes, CA 90275-5343

Mailing address

30822 Via Rivera
Rancho Palos Verdes, CA 90275-5343
Phone (310) 619-9528

Other identifiers 1

IdentifierTypeStateIssuer
00G673780MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110127000296 CA Practitioner - Pediatric Medicine 2860671567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Rush Medical College of Rush University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Care Medical Clinic IncGroup PAC ID 8729200076, 2 clinicians

Practice addresses (Care Compare)

1110 W Anaheim St
Suite 6
Wilmington, CA 90744-4131
Phone (310) 872-3560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G67378CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Medical Clinic Inc CurrentSince Apr 1, 2022 Accepting new patients
Pediatric Hospitalists of America Past Accepting new patients

Locations

10024 S Vermont Ave
Los Angeles, CA 90044
Phone (323) 242-0139

1110 W Anaheim St
Ste 6
Wilmington, CA 90744
Phone (310) 753-2468

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962569616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30822 VIA RIVERA",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755343",
            "telephone_number": "310-619-9528",
            "fax_number": "310-206-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30822 VIA RIVERA",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755343",
            "telephone_number": "310-619-9528",
            "fax_number": "310-206-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEYGIN",
        "first_name": "POLINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G67378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G673780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

Verify at the official NPI Registry.