ANDREA MARIE POLO FNP
NPI 1093393951
Nurse Practitioner in Portland, OR
About Andrea Marie Polo Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREA MARIE POLO FNP (NPI 1093393951) is an individual nurse practitioner in Portland, Oregon, licensed in Oregon (10031339) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Walnut Creek, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
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
Andrea Marie Polo Fnp 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.
Medicare Billing Reassignments
4Medicare enrollment records show Andrea Polo reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Portland, OR 97210
- Reassigned Medicare billing, Oregon and Washington enrollments
- Also billed through NPI 1255102034 (Washington)
- 41 clinicians in this Medicare group
Bothell, WA 98021
- Reassigned Medicare billing, Washington enrollment
- 207 clinicians in this Medicare group
Lancaster, CA 93534
- Reassigned Medicare billing, California enrollment
- 339 clinicians in this Medicare group
Diamond Bar, CA 91765
- Reassigned Medicare billing, California enrollment
- 283 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Andrea Polo's NPI number?
The NPI number for Andrea Polo is 1093393951. It was assigned to this individual provider in the NPPES registry on March 31, 2021.
Where is Andrea Polo located?
Andrea Polo practices at 6035 SE Milwaukie Ave, Portland, OR 97202. The listed phone number is (971) 258-1120.
What is Andrea Polo's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Andrea Polo enrolled in Medicare?
Yes. Andrea Polo 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 organizations bill Medicare for Andrea Polo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Polo reassigns Medicare benefits to 4 organizations: Uptown Providers PC (Portland, OR), Molina Healthcare Of Washington, Inc (Bothell, WA), Molina Healthcare Of California (Lancaster, CA) and Central Health Plan Of California, Inc. (Diamond Bar, CA). Each 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 Andrea Polo'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 Andrea Polo was last updated on November 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.
# Andrea Marie Polo, FNP · NPI 1093393951
Nurse Practitioner physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since March 31, 2021.
## Identity
- **NPI:** 1093393951 (Entity type: Individual)
- **Enumerated:** March 31, 2021
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 10031339 (Oregon)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6035 SE MILWAUKIE AVE, Portland, OR 97202-5344
- **Phone:** (971) 258-1120 · **Fax:** (866) 309-2838
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Uptown Providers PC (NPI 1144598293, Portland, OR); Molina Healthcare Of Washington, Inc (NPI 1659897163, Bothell, WA); Molina Healthcare Of California (NPI 1508970955, Lancaster, CA); Central Health Plan Of California, Inc. (NPI 1386714772, Diamond Bar, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** November 23, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1093393951) · Data from the CMS NPPES public registry.