Polly S Vaughan, CRNP - Medicare Nurse Practitioner in Hamilton, OH

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Polly S Vaughan, CRNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Hamilton, Ohio. She graduated from nursing school in 2007 and has 17 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Kettering Independent Medical Group Inc, Family Service Association and her current practice location is 630 Eaton Ave # 2w, Hamilton, Ohio. You can reach out to her office (for appointments etc.) via phone at (513) 867-2433.

Polly S Vaughan is licensed to practice in Ohio (license number APRN.CNP.09551) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1063609287.

Contact Information

Polly S Vaughan, CRNP
630 Eaton Ave # 2w,
Hamilton, OH 45013
(513) 867-2433
(513) 867-2499

Map and Direction




Provider's Profile

Full NamePolly S Vaughan
GenderFemale
SpecialityNurse Practitioner
Experience17 Years
Location630 Eaton Ave # 2w, Hamilton, Ohio
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Polly S Vaughan graduated from nursing school in 2007
  NPI Data:
  • NPI Number: 1063609287
  • Provider Enumeration Date: 10/02/2007
  • Last Update Date: 01/25/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3375625320
  • Enrollment ID: I20080129000682

Medical Identifiers

Medical identifiers for Polly S Vaughan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063609287NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics NP-09551 (Ohio)Secondary
363LF0000XNurse Practitioner - Family APRN.CNP.09551 (Ohio)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health APRN.CNP.09551 (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Kettering Medical Center - SycamoreMiamisburg, OHHospital
Fort Hamilton Hughes Memorial HospitalHamilton, OHHospital

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. Polly S Vaughan allows following entities to bill medicare on her behalf.
Entity NameAlliance Physicians Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437125572
PECOS PAC ID: 0840104360
Enrollment ID: O20031118000529
Entity NameFamily Service Association
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063442390
PECOS PAC ID: 7618948423
Enrollment ID: O20040804001481
Entity NameKettering Independent Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629387865
PECOS PAC ID: 3173710936
Enrollment ID: O20101207000425
Entity NameFairway Behavioral Health, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780328344
PECOS PAC ID: 1951787332
Enrollment ID: O20221008000405

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. Polly S Vaughan 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 AddressPractice Location Address
Polly S Vaughan, CRNP
6100 Gurneyville Rd,
Wilmington, OH 45177-6508

Ph: (937) 313-4400		Polly S Vaughan, CRNP
630 Eaton Ave # 2w,
Hamilton, OH 45013

Ph: (513) 867-2433

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.