Dr Mark-allen Nison Polyakov, MD in Fond Du Lac, WI

Dr Mark-allen Nison Polyakov, MD is a medicare enrolled "Hospitalist" physician in Fond Du Lac, Wisconsin. He graduated from medical school in 2011 and has 13 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Providence Medical Foundation and his current practice location is 430 E Division St, Fond Du Lac, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 929-2300.

Dr Mark-allen Nison Polyakov is licensed to practice in Wisconsin (license number 69890) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1548556053.

Contact Information

	Dr Mark-allen Nison Polyakov, MD
	430 E Division St, Fond Du Lac, WI 54935-4560
	(920) 929-2300
	(920) 926-4857

Map and Direction

Physician's Profile

Full Name	Dr Mark-allen Nison Polyakov
Gender	Male
Speciality	Internal Medicine
Experience	13 Years
Location	430 E Division St, Fond Du Lac, Wisconsin
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Mark-allen Nison Polyakov graduated from medical school in 2011

NPI Data:

NPI Number: 1548556053
Provider Enumeration Date: 06/22/2011
Last Update Date: 04/18/2019

Medicare PECOS Information:

PECOS PAC ID: 7113145327
Enrollment ID: I20150817000889

Medical Identifiers

Medical identifiers for Dr Mark-allen Nison Polyakov such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548556053	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	19068 (Hawaii)	Secondary
207R00000X	Internal Medicine	A132011 (California)	Secondary
208M00000X	Hospitalist	69890 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Santa Rosa Memorial Hospital	Santa rosa, CA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Providence Medical Foundation	8921993205	1312

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Mark-allen Nison Polyakov allows following entities to bill medicare on his behalf.

Entity Name	Providence Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark-allen Nison Polyakov is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Mark-allen Nison Polyakov, MD 420 E Division St, Fond Du Lac, WI 54935-4560 Ph: () -	Dr Mark-allen Nison Polyakov, MD 430 E Division St, Fond Du Lac, WI 54935-4560 Ph: (920) 929-2300

Reviews and Comments

Hospitalist Doctors in Fond Du Lac, WI

Kasra A Milani, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 430 E Division St, Fond Du Lac, WI 54935 Phone: 920-929-2300
Nydia C Ros, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 430 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-4591
Dr. Galina S Petrinska, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 430 E Division St, Fond Du Lac, WI 54935 Phone: 920-929-2300 Fax: 718-579-4836
Dr. Hiwot Ayalew Gobezie, MD Hospitalist Medicare: Medicare Enrolled Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8420 Fax: 920-926-8913
Kristof T. Gehrke, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-929-2300
Amena Nazeer, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 430 E Division St, Fond Du Lac, WI 54935 Phone: 812-450-7338 Fax: 812-450-2193
Madhulika Lall, MD Hospitalist Medicare: Medicare Enrolled Practice Location: 430 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8332 Fax: 920-926-8370

Dr Mark-allen Nison Polyakov, MD - Medicare Internal Medicine in Fond Du Lac, WI