MAYRA IVELISSE CRUZ POLANCO M.D
NPI 1194913012
Internal Medicine in Jamaica Plain, MA

Q: What is Mayra Cruz Polanco's NPI number?

The NPI number for Mayra Cruz Polanco is 1194913012. It was assigned to this individual provider in the NPPES registry on October 4, 2007.

Q: What is Mayra Cruz Polanco's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since October 04, 2007PECOS EnrolledAccepts Medicare Assignment

545A CENTRE ST, JAMAICA PLAIN, MA 02130(617) 522-5464(617) 524-2966 Get Directions Write a Review

NPPES record last updated: November 26, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mayra Ivelisse Cruz Polanco M.d NPPES

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

MAYRA IVELISSE CRUZ POLANCO M.D (NPI 1194913012) is an individual internal medicine provider in Jamaica Plain, Massachusetts, licensed in Massachusetts (235402) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS, is affiliated with Beth Israel Deaconess Hospital - Needham, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1194913012

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameMAYRA IVELISSE CRUZ POLANCOCredential: M.D

Location Address545A CENTRE STJamaica Plain, MA 02130-2061

Mailing Address545a Centre StJamaica Plain, MA 02130-2061 · (617) 522-5464 · Fax (617) 524-2966

Phone(617) 522-5464

Fax(617) 524-2966

Sole ProprietorNo

Medical School CMSOtherGraduated 1993

Enumeration DateOctober 4, 2007

Last NPPES UpdateNovember 26, 2008

✔ NPI 1194913012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MA · 235402

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

545A CENTRE ST, Jamaica Plain, MA 02130

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Other Identifiers 2

Medicaid2156318MA

Medicare PIN000654401MA

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

Mayra Ivelisse Cruz Polanco 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 ID9830265339

PECOS Enrollment IDI20080908000161

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 12

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.

274 services143 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

78 services49 patients

Blood glucose (sugar) level 82947

A blood glucose level test measures the amount of sugar in your blood. It's often used to monitor and manage conditions like diabetes. High or low levels can indicate a health issue. The test is usually done by pricking your finger for a small blood sample.

75 services47 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

65 services65 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.

55 services44 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

42 services30 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

35 services35 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

27 services27 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

16 services16 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

15 services15 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

14 services14 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Beth Israel Deaconess Hospital - Needham

Acute Care Hospitals · Needham, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220083

Location148 Chestnut StreetNeedham, MA 02494 · Norfolk County

Emergency services

Beth Israel Deaconess Medical Center

Acute Care Hospitals · Boston, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220086

Location330 Brookline AvenueBoston, MA 02215 · Suffolk County

Emergency services Birthing friendly

Beth Israel Deaconess Hospital - Milton

Acute Care Hospitals · Milton, MA

4/5 CMS rating

OwnershipGovernment - Federal

CMS Certification Number220108

Location199 Reedsdale RoadMilton, MA 02186 · Norfolk County

Emergency services

Faulkner Hospital-Brigham And Women's

Acute Care Hospitals · Boston, MA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220119

Location1153 Centre StreetBoston, MA 02130 · Suffolk County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02130 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

$144.11 typical visit price

range $63.72 – $189.86

Typical copayment $36.02 (range $15.93 – $47.46)

Most-billed visit code 99204

Established Patient

$111.18 typical visit price

range $21.07 – $155.29

Typical copayment $27.79 (range $5.26 – $38.82)

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.

Referred Medical Equipment & Supplies CMS DME claims 10

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

15 suppliers37 claims86 services$6.03 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

12 suppliers25 claims33 services$1.14 avg. paid by Medicare

Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each A4389

DME-Orthotic Devices · category DF010N

1 supplier12 claims240 services$4.87 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

1 supplier22 claims22 services$34.91 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers21 claims21 services$14.88 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers11 claims11 services$1.15 avg. paid by Medicare

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

Other Providers at the Same Location NPPES 19

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

SUSAN KURIAKOSE NP

Nurse Practitioner