Tiffany E Polo, is a medicare enrolled "Nurse Practitioner" in King William, Virginia. She graduated from nursing school in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Richmond Heart And Vascular Associates, Bon Secours Memorial Regional Medical Center Llc and her current practice location is
1041 Sharon Rd, Suite 205, King William, Virginia. You can reach out to her office (for appointments etc.) via phone at
(804) 746-1677.
Tiffany E Polo is licensed to practice in Virginia (license number 0024172717) 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 1548640873.
Provider's Profile
| Full Name | Tiffany E Polo |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 9 Years |
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| Location | 1041 Sharon Rd, King William, Virginia |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Tiffany E Polo graduated from nursing school in 2015
NPI Data:
- NPI Number: 1548640873
- Provider Enumeration Date: 06/02/2015
- Last Update Date: 07/16/2015
Medicare PECOS Information:
- PECOS PAC ID: 5496060592
- Enrollment ID: I20150819006919
Medical Identifiers
Medical identifiers for Tiffany E Polo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1548640873 | NPI | - | NPPES |
| C05698 | Other | VA | GROUP PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 0024172717 (Virginia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Richmond Heart And Vascular Associates | 4385039718 | 18 |
| Bon Secours Memorial Regional Medical Center Llc | 6507775293 | 31 |
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. Tiffany E Polo allows following entities to bill medicare on her behalf.
| Entity Name | Bon Secours Memorial Regional Medical Center Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881795557
PECOS PAC ID: 6507775293
Enrollment ID: O20040726000687 |
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| Entity Name | Richmond Heart And Vascular Associates |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508519745
PECOS PAC ID: 4385039718
Enrollment ID: O20220321002135 |
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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. Tiffany E Polo 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 |
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Tiffany E Polo,
1041 Sharon Rd, Suite 205,
King William, VA 23086-3347
Ph: (804) 746-1677 | Tiffany E Polo,
1041 Sharon Rd, Suite 205,
King William, VA 23086-3347
Ph: (804) 746-1677 |
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