James Polly, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Indianapolis, Indiana. His current practice location is
1525 N Ritter Ave, Indianapolis, Indiana. You can reach out to his office (for appointments etc.) via phone at
(317) 359-5467.
James Polly is licensed to practice in Indiana (license number 34007026A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1336459429.
Healthcare Provider's Profile
| Full Name | James Polly |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 1525 N Ritter Ave, Indianapolis, Indiana |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1336459429
- Provider Enumeration Date: 10/07/2010
- Last Update Date: 10/07/2014
Medicare PECOS Information:
- PECOS PAC ID: 0143449611
- Enrollment ID: I20141120000335
Medical Identifiers
Medical identifiers for James Polly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1336459429 | NPI | - | NPPES |
| 100270530 | Medicaid | IN | |
| 000000892238 | Other | IN | ANTHEM |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (Indiana) | Secondary |
| 1041C0700X | Social Worker - Clinical | 34007026A (Indiana) | 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. James Polly allows following entities to bill medicare on his behalf.
| Entity Name | Deer Oaks Illinois Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1316345291
PECOS PAC ID: 8628375730
Enrollment ID: O20160404001576 |
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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. James Polly 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 |
|---|
James Polly, LCSW
6626 E 75th Street, Suite 500,
Indianapolis, IN 46250-2890
Ph: () - | James Polly, LCSW
1525 N Ritter Ave,
Indianapolis, IN 46219-3026
Ph: (317) 359-5467 |
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