Carolyn G. Polcari, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA60999591 Issued in WA

Practice address

510 8TH Ave NE Ste 200
Issaquah, WA 98029-5436

Phone

(425) 392-3030

Fax

(425) 392-2564

NPI assigned

Sep 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463

  Surgical

  NPD
• Proliance Surgeons Inc., P.S.

  • Surgery Physician
  • Edmonds, WA
  • NPI 1073540894

  Surgical

  NPD

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1972050565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-392-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 200",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-392-3030",
            "fax_number": "425-392-2564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7712 San Jacinto Pl",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750243257",
            "country_code": "US",
            "telephone_number": "214-448-3363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1231 116th Ave NE Ste 750",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980043812",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18100 NE Union Hill Rd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980523330",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLCARI",
        "first_name": "CAROLYN",
        "middle_name": "G.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60999591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard John Plunkett, M.D.
• Debra Lynne Poepping, LMFT
• Nicole Pohlers, LMHC
• Lynzi C. Poje, PA-C
• Smita Pokle-Soans, LMP
• Anna Sarai Polk Tyler
• Jason Lynn Polk, D.C.
• Mitsuko Pollard, PH.D.
• Katherine Pond
• Deanna Poneman, D.C.

• Surgical Physician Assistant in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.