Individual provider Active NPI

Ingrid C Polcari, M.D.

  • Pediatric Dermatology Physician
  • Minneapolis, MN
National Provider Identifier
1992976716
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
54976 Issued in MN
Practice address
2450 Riverside Ave
12TH Floor Explorer Clinic
Minneapolis, MN 55454-1450
Phone
(612) 365-6777
NPI assigned
Mar 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036120215 IL
Pediatric Dermatology Physician 207NP0225X 54976 MN Primary

Addresses

Primary practice location

2450 Riverside Ave
12TH Floor Explorer Clinic
Minneapolis, MN 55454-1450

Mailing address

420 Delaware St SE
Mayo Mail Code 98
Minneapolis, MN 55455-0392
Phone (612) 625-8625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20120905000626 MN Practitioner - DermatologyPractitioner - Pediatric Medicine 7012164536 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pediatric Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54976MNMDPediatric Dermatology Physician
036120215ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Aug 15, 2012 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Aug 15, 2012 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Cardiothoracic Surgery Clinic of North Ms Past Accepting new patients
Fairview Health Services Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

2450 Riverside Ave
Fl 12
Minneapolis, MN 55454
Phone (612) 273-5000

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

420 Delaware St SE
#98
Minneapolis, MN 55455
Phone (612) 624-9964

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

9680 Tamarack Rd
Ste 130
Woodbury, MN 55125
Phone (612) 273-1172

Interoperability endpoints

  • Direct secure messaging: ipolcari281846@fairview.direct-ci.com

Organizations & group practices 10

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": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1992976716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MAYO MAIL CODE 98",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550392",
            "telephone_number": "612-625-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "address_2": "12TH FLOOR EXPLORER CLINIC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-365-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLCARI",
        "first_name": "INGRID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036120215",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "MN",
            "license": "54976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.