MR. MARIO POLANCO B.S, DEGREE
NPI 1073640587
Physical Therapist in Los Angeles, CA
About Mr. Mario Polanco B.s, Degree NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. MARIO POLANCO B.S, DEGREE (NPI 1073640587) is an individual physical therapist in Los Angeles, California, licensed in California (11680) and active in the NPI registry since February 2007.
NPPES Registry Identity
Specialties & Licenses 2
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Mario Polanco B.s, Degree is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mario Polanco reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90048
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Ilya Kaminsky Dc A Professional Corporation
- 11 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
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.
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90022
LOS ANGELES, CA 90022
LOS ANGELES, CA 90022
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mario Polanco's NPI number?
The NPI number for Mario Polanco is 1073640587. It was assigned to this individual provider in the NPPES registry on February 28, 2007.
Where is Mario Polanco located?
Mario Polanco practices at 5301 Whittier Blvd Atrium Suite, Los Angeles, CA 90022. The listed phone number is (323) 887-7458.
What is Mario Polanco's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Mario Polanco enrolled in Medicare?
Yes. Mario Polanco is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mario Polanco's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mario Polanco reassigns Medicare benefits to Kaminsky Physical Therapy, Inc. (Los Angeles, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mario Polanco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mario Polanco was last updated on December 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.