KEVIN L POLGLAZE DO
NPI 1053555367
Emergency Medicine in Oshkosh, WI

Q: What is Kevin Polglaze's NPI number?

The NPI number for Kevin Polglaze is 1053555367. It was assigned to this individual provider in the NPPES registry on April 30, 2009.

Q: What is Kevin Polglaze's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Polglaze was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 30, 2009PECOS EnrolledAccepts Medicare Assignment

855 N WESTHAVEN DR, OSHKOSH, WI 54904(920) 456-7400(920) 456-7421 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2026, Apr 11, 2024, Apr 7, 2022 and 1 more (4 updates tracked since 2020).

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About Kevin L Polglaze Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN L POLGLAZE DO (NPI 1053555367) is an individual emergency medicine provider in Oshkosh, Wisconsin, licensed in Wisconsin (52673-021) and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Manitowoc County, and maintains a secondary practice location in Green Bay.

NPPES Registry Identity

NPI1053555367

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameKEVIN L POLGLAZECredential: DO

Location Address855 N WESTHAVEN DROshkosh, WI 54904-7668

Mailing Address1035 Kepler DrGreen Bay, WI 54311-8320 · (920) 490-9046 · Fax (920) 405-8005

Phone(920) 456-7400

Fax(920) 456-7421

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateApril 30, 2009

Last NPPES UpdateMay 19, 20264 updates tracked since enumeration

NPPES CertifiedMay 19, 2026

✔ NPI 1053555367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in WI · 52673-021

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

855 N WESTHAVEN DR, Oshkosh, WI 54904

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Secondary Practice Location 1

Location 12845 Greenbrier RdGreen Bay, WI 54311-6519 · Phone (920) 490-9046

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin L Polglaze Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133270960

PECOS Enrollment IDI20090707000664

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

98 services92 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

60 services60 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

58 services57 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

23 services23 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

18 services18 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

15 services15 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Aurora Medical Ctr Manitowoc County

Acute Care Hospitals · Two Rivers, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number520034

Location5000 Memorial DriveTwo Rivers, WI 54241 · Manitowoc County

Emergency services Birthing friendly

Aurora Baycare Medical Ctr

Acute Care Hospitals · Green Bay, WI

5/5 CMS rating

OwnershipProprietary

CMS Certification Number520193

Location2845 Greenbrier RdGreen Bay, WI 54311 · Brown County

Emergency services Birthing friendly

Aurora Medical Ctr Oshkosh

Acute Care Hospitals · Oshkosh, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520198

Location855 N Westhaven DriveOshkosh, WI 54904 · Winnebago County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54904 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%787 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACQUELINE ANN OTS PENDING

Nurse Practitioner