KENNETH D POLIVY M.D.
NPI 1194794115
Orthopaedic Surgery in Newton, MA

Q: What is Kenneth Polivy's NPI number?

The NPI number for Kenneth Polivy is 1194794115. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Q: What is Kenneth Polivy's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Polivy was last updated on November 1, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 14, 2006PECOS EnrolledAccepts Medicare Assignment

2000 WASHINGTON ST, SUITE 341, NEWTON, MA 02462(617) 964-0024(617) 964-6374 Get Directions Write a Review

NPPES record last updated: November 1, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Kenneth D Polivy M.d. NPPES

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

KENNETH D POLIVY M.D. (NPI 1194794115) is an individual orthopaedic surgery provider in Newton, Massachusetts, licensed in Massachusetts (47345) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Emerson Hospital -, and is a graduate of Tufts University School Of Medicine (1978).

NPPES Registry Identity

NPI1194794115

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameKENNETH D POLIVYCredential: M.D.

Location Address2000 WASHINGTON ST, SUITE 341Newton, MA 02462-1650

Mailing Address2000 Washington St, Suite 341Newton, MA 02462-1650 · (617) 964-0024 · Fax (617) 964-6374

Phone(617) 964-0024

Fax(617) 964-6374

Sole ProprietorNo

Medical School CMSTufts University School Of MedicineGraduated 1978

Enumeration DateMarch 14, 2006

Last NPPES UpdateNovember 1, 2011

✔ NPI 1194794115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in MA · 47345

Definition

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.

2000 WASHINGTON ST, Newton, MA 02462

Open in Google Maps ↗

Other Identifiers 6

Other047345MA · Tufts

OtherJ03453MA · Bcbs

Medicare ID-Type UnspecifiedJ03453MA

Medicaid6183484MA

Other17266MA · Harvard Pilgrim

Medicare UPINA57025MA

Accepted Insurance

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

Kenneth D Polivy M.d. 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 ID42287518

PECOS Enrollment IDI20050324000134

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 21

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.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967

Low 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.

1,051 services18 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This 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.

403 services239 patients

X-ray lower and sacral spine, minimum of 6 views 72114

An 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.

311 services154 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.

238 services224 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

This 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.

203 services123 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone 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.

184 services55 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This 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.

112 services112 patients

X-ray of lower and sacral spine, 2-3 views 72100

An 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.

96 services39 patients

Aspiration and/or injection of fluid from large joint 20610

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.

82 services58 patients

X-ray of upper spine, 6 or more views 72052

An 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.

79 services40 patients

X-ray of hip, 2-3 views 73502

An 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.

76 services37 patients

X-ray of shoulder, minimum of 2 views 73030

An 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.

64 services29 patients

X-ray of foot, minimum of 3 views 73630

An 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.

47 services17 patients

X-ray of knee, 4 or more views 73564

An 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.

46 services22 patients

X-ray of knee, 3 views 73562

An 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.

37 services17 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A 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.

30 services16 patients

Fluoroscopic guidance for needle placement 77002

Fluoroscopic 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.

27 services18 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An 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.

26 services13 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

24 services11 patients

X-ray of middle spine, 2 views 72070

An 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.

22 services11 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level 64484

This 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.

19 services16 patients

Hospital Affiliations CMS Care Compare 3

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

Emerson Hospital -

Acute Care Hospitals · W Concord, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220084

Location133 Old Road To 9 Acre CornerW Concord, MA 01742 · Middlesex County

Emergency services Birthing friendly

Newton-Wellesley Hospital

Acute Care Hospitals · Newton, MA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220101

Location2014 Washington StreetNewton, MA 02462 · Middlesex County

Emergency services Birthing friendly

Brigham And Women's Hospital

Acute Care Hospitals · Boston, MA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220110

Location75 Francis StreetBoston, MA 02115 · Suffolk County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02462 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

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

Most-billed visit code 99213

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

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

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 L0627

DME-Orthotic Devices · category DF007N

1 supplier11 claims11 services$334.63 avg. paid by Medicare

Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment L1820

DME-Orthotic Devices · category DF011N

1 supplier16 claims16 services$108.63 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Leave this field empty

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.

BRUCE ALDEN THAYER M.D.

Surgery

2000 WASHINGTON ST, SUITE 665
NEWTON, MA 02462

Middlesex County (617) 243-3724

DR. MATTHIAS BERNARD DONELAN MD

Plastic Surgery

2000 WASHINGTON ST
NEWTON LOWER FALLS, MA 02462

Middlesex County (617) 244-0990

DR. BRINDA TRIVEDI GUPTA MD

Pediatrics

2000 WASHINGTON ST, SUITE 466
NEWTON, MA 02462

Middlesex County (617) 969-8989

NEW ENGLAND EAR NOSE AND THROAT LLC

Otolaryngology (Otolaryngology/Facial Plastic Surgery)

2000 WASHINGTON ST, SUITE 544 WHITE BUILDING
NEWTON, MA 02462

Middlesex County (617) 910-0368

NICHOLAS MICHAEL MASCOLI III M.D.

Internal Medicine

2000 WASHINGTON ST, SUITE 546
NEWTON LOWER FALLS, MA 02462

Middlesex County (617) 964-5020

BRUCE M. LESLIE M.D.

Orthopaedic Surgery (Hand Surgery)

2000 WASHINGTON ST, SUITE 341
NEWTON, MA 02462

Middlesex County (617) 964-0024

TARA A GRABOWSKY M.D.

Internal Medicine

2000 WASHINGTON ST, SUITE 441
NEWTON, MA 02462

Middlesex County (617) 964-9070

ANN WANG-DOHLMAN, MD, PC

Allergy & Immunology (Allergy)

2000 WASHINGTON ST, SUITE 205
NEWTON, MA 02462

Middlesex County (617) 527-3440

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 Kenneth Polivy's NPI number?

The NPI number for Kenneth Polivy is 1194794115. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Where is Kenneth Polivy located?

Kenneth Polivy practices at 2000 Washington St Suite 341, Newton, MA 02462. The listed phone number is (617) 964-0024.

What is Kenneth Polivy's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Kenneth Polivy enrolled in Medicare?

Yes. Kenneth Polivy 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.

What insurance does Kenneth Polivy accept?

Health plans from Anthem Blue Cross and Blue Shield list Kenneth Polivy 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 Kenneth Polivy affiliated with any hospitals?

According to CMS data, Kenneth Polivy is affiliated with Emerson Hospital -, Newton-Wellesley Hospital and Brigham And Women's Hospital.

When was this NPI record last updated?

The NPPES record for Kenneth Polivy was last updated on November 1, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.