Amy E Poliak, NP in Appleton, WI - Medicare Nurse Practitioner

Amy E Poliak, NP is a medicare enrolled "Nurse Practitioner - Family" in Appleton, Wisconsin. Her current practice location is 1506 S Oneida St, Appleton, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 730-4959.

Amy E Poliak is licensed to practice in Wisconsin (license number 4443) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1851694285.

Contact Information

	Amy E Poliak, NP
	1506 S Oneida St, Appleton, WI 54915-1305
	(920) 730-4959
	Not Available

Map and Direction

Provider's Profile

Full Name	Amy E Poliak
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1506 S Oneida St, Appleton, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1851694285
Provider Enumeration Date: 12/07/2010
Last Update Date: 01/03/2023

Medicare PECOS Information:

PECOS PAC ID: 2062680259
Enrollment ID: I20110713000621

Medical Identifiers

Medical identifiers for Amy E Poliak such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1851694285	NPI	-	NPPES
100014952	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	175436 (Wisconsin)	Secondary
363LF0000X	Nurse Practitioner - Family	4443 (Wisconsin)	Primary

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. Amy E Poliak allows following entities to bill medicare on her behalf.

Entity Name	Ascension Medical Group-fox Valley Wisconsin Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730126392 PECOS PAC ID: 0244142420 Enrollment ID: O20031105000351

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. Amy E Poliak 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
Amy E Poliak, NP 1506 S Oneida St, Appleton, WI 54915-1305 Ph: (920) 730-4959	Amy E Poliak, NP 1506 S Oneida St, Appleton, WI 54915-1305 Ph: (920) 730-4959

Reviews and Comments

Nurse Practitioner Nurses in Appleton, WI

Ann M Hefter, AGACNP-BC, MSN, BSN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-731-8900
Dessia J Laxton, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-731-8900 Fax: 920-738-5369
Katie Geiser, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5045 W Grande Market Dr, Appleton, WI 54913 Phone: 920-886-9380
Ingrid K Simpson, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2400 E Capitol Dr, Appleton, WI 54911 Phone: 920-831-5050 Fax: 920-831-1867
Lisa Valiquette, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2500 E Capitol Dr, Appleton, WI 54911 Phone: 920-738-4600 Fax: 920-738-4792
Kimberly A Romenesko, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-735-7645 Fax: 920-735-7618
Steven R Hamel, APN FP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3925 N Gateway Dr, Appleton, WI 54913 Phone: 920-830-6877

Amy E Poliak, NP - Medicare Nurse Practitioner in Appleton, WI