ALEX JOHN POLENICK (NPI# 1003397654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003397654 |
| Entity Type | Individual |
| Full Name | ALEX JOHN POLENICK |
| Credential | PA-C |
| Practice Address |
1499 Boardman Canfield Rd Boardman OH 44512-4008 |
| Mailing Address |
6470 Tippecanoe Road Canfield OH 44406-7036 |
| Practice Telephone | 3307580577 |
| Practice Fax Number | 3305334587 |
| Mailing Telephone | 3307580577 |
| Mailing Fax Number | 3307580466 |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
50.005589RX | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1499 BOARDMAN CANFIELD RD |
| City | BOARDMAN |
| State | OH |
| Zip Code | 44512-4008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669475380 | James P Jamison | Orthopaedic Surgery | 1499 Boardman Canfield Rd, Boardman, OH 44512-4008 | 2005-05-27 |
| 1477972800 | Matthew A Mcelroy | Physical Medicine & Rehabilitation | 1499 Boardman Canfield Rd, Boardman, OH 44512-4008 | 2014-04-14 |
| 1083825855 | David Weimer | Orthopaedic Surgery | 1499 Boardman Canfield Rd, Boardman, OH 44512-4008 | 2007-05-24 |
| 1811020936 | Brad Matthew Picha | Orthopaedic Surgery | 1499 Boardman Canfield Rd, Boardman, OH 44512-4008 | 2007-03-14 |
| 1295812113 | Franklin E Ansevin | Physician Assistant | 1499 Boardman Canfield Rd, Boardman, OH 44512-4008 | 2006-11-01 |
| 1427007509 | Bohdan S Ploskodniak | Physician Assistant | 1499 Boardman Canfield Rd, Boardman, OH 44512-4008 | 2006-05-08 |
| 1881697225 | Youngstown Orthopaedic Associates Ltd | Orthopaedic Surgery | 1499 Boardman Canfield Rd, Boardman, OH 44512-4008 | 2005-05-31 |
| 1821091414 | Douglas H Musser | Orthopaedic Surgery | 1499 Boardman Canfield Rd, Boardman, OH 44512-4008 | 2005-05-27 |
| 1780687376 | Kevin D Waskin | Physician Assistant | 1499 Boardman Canfield Rd, Boardman, OH 44512-4008 | 2005-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891161196 | Allison Pauly | Physician Assistant | 910 Boardman Canfield Rd, Boardman, OH 44512-4218 | 2015-08-20 |
| 1548320302 | David M Collins | Physician Assistant | 450 Tatone Street, Boardman, OR 97818 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618428 | Stephanie Ann Keener | Physician Assistant | 7774 Hythe Cir, Centerville, OH 45459-8705 | 2020-10-27 |
| 1174122600 | Maria Drankov Lane | Physician Assistant | 1806 Muskegon Dr, Cincinnati, OH 45255-2635 | 2020-10-26 |
| 1326647512 | Junell Rutledge | Physician Assistant | 644 High St, Youngstown, OH 44502-1562 | 2020-10-20 |
| 1699372383 | Samantha Kibler | Physician Assistant | 7337 Caritas Cir Nw Ste 150, Massillon, OH 44646-9128 | 2020-10-06 |
| 1982218186 | Morgan Holmes | Physician Assistant | 65 Community Rd Ste F, Tallmadge, OH 44278-2358 | 2020-09-04 |
| 1902456023 | Kara Meyer | Physician Assistant | 2417 Derbyshire Ct, Cleveland Heights, OH 44106-2778 | 2019-09-19 |
| 1679122394 | Mariah Bower | Physician Assistant | 2725 Hampshire Rd Apt 3, Cleveland, OH 44106-2570 | 2019-09-05 |
| 1457908014 | Kristen Fairchild | Physician Assistant | 4235 Secor Rd Bldg 2, Toledo, OH 43623-4231 | 2019-08-19 |
| 1811549462 | Abigail Malsch | Physician Assistant | 2376 Fenwood Rd, University Heights, OH 44118-3804 | 2019-07-14 |
| 1164087466 | Jessica Lee Schulte | Physician Assistant | 1110 West Main Cross St., Findlay, OH 45840-2423 | 2019-05-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ALEX JOHN POLENICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.