KENNETH D POLIVY M.D.
NPI 1194794115
Orthopaedic Surgery in Newton, MA
NPI Status: Active since March 14, 2006
Contact Information
2000 WASHINGTON ST
SUITE 341
NEWTON, MA
ZIP 02462
Phone: (617) 964-0024
Fax: (617) 964-6374
- Individual
- Male
- Years of Experience 48
- Orthopaedic Surgery
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About KENNETH POLIVY
This page provides the complete NPI Profile along with additional information for Kenneth Polivy, a provider established in Newton, Massachusetts with a medical specialization in Orthopaedic Surgery and more than 48 years of experience. He graduated from Tufts University School Of Medicine in 1978. The healthcare provider is registered in the NPI registry with number 1194794115 assigned on March 2006. The practitioner's primary taxonomy code is 207X00000X with license number 47345 (MA). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1194794115
- Provider Name
- KENNETH D POLIVY M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2000 WASHINGTON ST SUITE 341 NEWTON, MA 02462
- Location Phone
- (617) 964-0024
- Location Fax
- (617) 964-6374
- Mailing Address
- 2000 WASHINGTON ST SUITE 341 NEWTON, MA 02462
- Mailing Phone
- (617) 964-0024
- Mailing Fax
- (617) 964-6374
- Medical School Name
- TUFTS UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1978
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-14-2006
- Last Update Date
- 11-01-2011
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 47345
- License State
- MA
- Taxonomy Description
- An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 047345 | OTHER (01) | MA | TUFTS |
| J03453 | OTHER (01) | MA | BCBS |
| J03453 | MEDICARE ID-TYPE UNSPECIFIED (04) | MA | |
| 6183484 | MEDICAID (05) | MA | |
| 17266 | OTHER (01) | MA | HARVARD PILGRIM |
| A57025 | MEDICARE UPIN (02) | MA |
Medicare Participation & PECOS Enrollment Status
Kenneth Polivy is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Kenneth Polivy is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 42287518
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20050324000134
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Orthotic Devices
DME-Orthotic Devices (DF007N)
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise (HCPCS:L0627)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Orthotic Devices (DF011N)
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment (HCPCS:L1820)
1 DME suppliers used 16 Medicare Claims 16 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Dxa bone density measurement of hip, pelvis, spine
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Fluoroscopic guidance for needle placement
Hyaluronan or derivative, gel-one, for intra-articular injection, per dose
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
Injection, methylprednisolone acetate, 40 mg
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
X-ray lower and sacral spine, minimum of 6 views
X-ray of both knees while standing
X-ray of foot, minimum of 3 views
X-ray of hip, 2-3 views
X-ray of knee, 3 views
X-ray of knee, 4 or more views
X-ray of lower and sacral spine, 2-3 views
X-ray of lower and sacral spine, minimum of 4 views
X-ray of middle spine, 2 views
X-ray of pelvis, 1-2 views
X-ray of shoulder, minimum of 2 views
X-ray of upper spine, 6 or more views
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 273 times for 220 patientsA DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.
This service was performed 25 times for 15 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 356 times for 255 patientsThis 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.
This service was performed 319 times for 270 patientsFluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.
This service was performed 249 times for 150 patientsHyaluronan or Gel-One is a substance injected directly into your joint space. It's aimed to supplement your body's natural joint fluid, helping to lubricate and cushion the joint, reducing pain and improving mobility. It's often used for arthritis relief.
This service was performed 18 times for 14 patientsThis procedure involves injecting an anesthetic or steroid drug into the sacral spine nerve root. It's done under imaging guidance to ensure accuracy. The process can be repeated for each additional level of the spine to help manage pain or inflammation.
This service was performed 33 times for 22 patientsThis procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.
This service was performed 237 times for 148 patientsMethylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.
This service was performed 1,284 times for 335 patientsTriamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
This service was performed 96 times for 23 patientsLow osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
This service was performed 9,350 times for 151 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 102 times for 102 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 12 times for 12 patientsAn X-ray of the lower and sacral spine involves capturing images of the bones in your lower back and tailbone area. It helps to identify issues like fractures, infections, or degenerative diseases. A minimum of 6 views ensures a comprehensive examination.
This service was performed 352 times for 184 patientsAn X-ray of both knees while standing is a diagnostic procedure that captures images of your knee joints. You'll stand in front of an X-ray machine, and it will take pictures showing the bones and tissues in your knees. This helps doctors identify any abnormalities or injuries.
This service was performed 22 times for 11 patientsAn X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
This service was performed 47 times for 16 patientsAn X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
This service was performed 180 times for 88 patientsAn X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
This service was performed 25 times for 13 patientsAn X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
This service was performed 109 times for 57 patientsAn X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.
This service was performed 90 times for 44 patientsAn X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.
This service was performed 22 times for 13 patientsAn X-ray of the middle spine, or thoracic spine, involves capturing two different images of the area. This non-invasive procedure uses small amounts of radiation to visualize the bones and tissues in your back, helping to identify any abnormalities or injuries.
This service was performed 35 times for 16 patientsAn X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.
This service was performed 30 times for 15 patientsAn X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
This service was performed 69 times for 37 patientsAn X-ray of the upper spine with 6 or more views involves capturing multiple images of your neck and upper back. This non-invasive procedure helps doctors visualize the bones and joints, aiding in diagnosing conditions such as arthritis, fractures, or spinal deformities.
This service was performed 68 times for 36 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $24.41 for a new patient copayment and $19.71 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 02462 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $97.64
- Minimum New Patient Price $63.72
- Maximum New Patient Price $189.86
- Average New Patient Copayment $24.41
- Minimum New Patient Copayment $15.93
- Maximum New Patient Copayment $47.46
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $78.84
- Minimum Established Patient Price $21.07
- Maximum Established Patient Price $155.29
- Average Established Patient Copayment $19.71
- Minimum Established Patient Copayment $5.26
- Maximum Established Patient Copayment $38.82
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kenneth Polivy is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| NEWTON-WELLESLEY HOSPITAL | 2014 WASHINGTON STREET NEWTON, MA 02462 | (617) 243-6000 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1194794115, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
NEWTON, MA 02462
NEWTON LOWER FALLS, MA 02462
NEWTON, MA 02462
NEWTON, MA 02462
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194794115, enumerated as an "individual" on March 14, 2006.
The provider is located at 2000 WASHINGTON ST SUITE 341 NEWTON, MA 02462 and the phone number is (617) 964-0024.
Orthopaedic Surgery with taxonomy code 207X00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Tufts Health. Please consult your insurance carrier or call the provider to verify.
Kenneth Polivy is affiliated with: NEWTON-WELLESLEY HOSPITAL.
