1. Home
  2. Directory
  3. North Carolina
  4. Charlotte
  5. Nurse Practitioner
  6. NPI Profile

KIMBERLY HANSEN POLONSKY FNP-BC
NPI 1073954590
Nurse Practitioner in Charlotte, NC

Active since July 12, 2013PECOS EnrolledAccepts Medicare Assignment
1918 RANDOLPH RD STE 275, CHARLOTTE, NC 28207(704) 384-1354(704) 384-1374 Get Directions Write a Review

NPPES record last updated: July 29, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 29, 2024, Jul 15, 2021, May 26, 2021 and 3 more (6 updates tracked since 2016).

About Kimberly Hansen Polonsky Fnp-bc NPPES

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

KIMBERLY HANSEN POLONSKY FNP-BC (NPI 1073954590) is an individual nurse practitioner in Charlotte, North Carolina, licensed in North Carolina (5006279) and active in the NPI registry since July 2013. She is enrolled in Medicare PECOS, is affiliated with Novant Health Presbyterian Medical Center, and maintains a secondary practice location in Charlotte.

NPPES Registry Identity

NPI1073954590
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKIMBERLY HANSEN POLONSKYCredential: FNP-BC
Location Address1918 RANDOLPH RD STE 275Charlotte, NC 28207-1109
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Phone(704) 384-1354
Fax(704) 384-1374
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJuly 12, 2013
Last NPPES UpdateJuly 29, 20246 updates tracked since enumeration
NPPES CertifiedJuly 29, 2024
✔ NPI 1073954590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in NC · 5006279
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 236192 (NC)
1918 RANDOLPH RD STE 275, Charlotte, NC 28207
Open in Google Maps ↗

Secondary Practice Location 1

Location 15301 Wilkinson BlvdCharlotte, NC 28208-5455 · Phone (704) 316-6561 · Fax (704) 384-1977

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimberly Hansen Polonsky Fnp-bc 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 ID8820226558
PECOS Enrollment IDI20170512000048
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.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Polonsky reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Novant Health Medical Group, LLC
Same address
Pediatric Gastroenterology
1918 RANDOLPH RD STE 210
Charlotte, NC 28207
  • Reassigned Medicare billing, North Carolina enrollment
  • 2,998 clinicians in this Medicare group
NPI 1003966185 (704) 316-5060

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

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.

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.
41 services28 patients

Hospital Affiliations CMS Care Compare

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

Novant Health Presbyterian Medical Center

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340053
Location200 Hawthorne Lane Box 33549Charlotte, NC 28233 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28207 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

Other Providers at the Same Location NPPES 7

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

THAMRAH RHOXANA ADEBIMPE M.D.
Family Medicine
1918 RANDOLPH RD STE 275
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-1354
DR. KARAN PRABODH SHUKLA M.D.
Family Medicine
1918 RANDOLPH RD STE 275
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-1354
KEYUNNA SHARON AUSTIN DO
Family Medicine
1918 RANDOLPH RD STE 275
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-1354
MARTHA MARY BRINSKO NP
Nurse Practitioner
1918 RANDOLPH RD STE 275
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-1354
CHRISTOPHER TAYLOR HOUPT PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1918 RANDOLPH RD STE 275
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-1354
MELINDA R CARTER MD
Family Medicine
1918 RANDOLPH RD STE 275
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-1354
ABHAY KOMMANA DO
Family Medicine
1918 RANDOLPH RD STE 275
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-1354

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 Kimberly Polonsky's NPI number?

The NPI number for Kimberly Polonsky is 1073954590. It was assigned to this individual provider in the NPPES registry on July 12, 2013.

Where is Kimberly Polonsky located?

Kimberly Polonsky practices at 1918 Randolph Rd Ste 275, Charlotte, NC 28207. The listed phone number is (704) 384-1354.

What is Kimberly Polonsky's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kimberly Polonsky enrolled in Medicare?

Yes. Kimberly Polonsky is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kimberly Polonsky's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Polonsky reassigns Medicare benefits to Novant Health Medical Group, LLC (Charlotte, NC). 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 Kimberly Polonsky's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Polonsky accept?

Health plans from Blue Cross and Blue Shield of NC list Kimberly Polonsky as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kimberly Polonsky affiliated with any hospitals?

According to CMS data, Kimberly Polonsky is affiliated with Novant Health Presbyterian Medical Center.

When was this NPI record last updated?

The NPPES record for Kimberly Polonsky was last updated on July 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.