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DR. GORDON M. POLLEY M. D.
NPI 1265490056
Surgery in Jacksonville, FL

Active since May 02, 2006PECOS Enrolled
79.26/100
CMS Quality Rating
836 PRUDENTIAL DR, SUITE 1001, JACKSONVILLE, FL 32207(904) 398-0033(904) 398-6774 Get Directions Write a Review

NPPES record last updated: July 28, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Gordon M. Polley M. D. NPPES

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

DR. GORDON M. POLLEY M. D. (NPI 1265490056) is an individual surgery provider in Jacksonville, Florida, licensed in Florida (ME51872) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265490056
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. GORDON M. POLLEYCredential: M. D.
Location Address836 PRUDENTIAL DR, SUITE 1001Jacksonville, FL 32207-8334
Mailing Address11945 San Jose Blvd, Bldg 300Jacksonville, FL 32223-1627 · (904) 396-1725 · Fax (904) 399-1717
Phone(904) 398-0033
Fax(904) 398-6774
Sole ProprietorNo
Enumeration DateMay 2, 2006
Last NPPES UpdateJuly 28, 2015
✔ NPI 1265490056 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in FL · ME51872
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
836 PRUDENTIAL DR, Jacksonville, FL 32207
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Other Identifiers 8

Other4664231Aetna
Medicaid274941600FL
Other12615Bcbs Fl
Medicare PIN12615XFL
Other1265866Cigna
Other020040220FL · Railroad Medicare
Other100414Avmed
Medicare UPINE97899

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Gordon M. Polley M. D. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Gordon Polley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Florida Surgeons, PA
11 mi
Surgery
11945 SAN JOSE BLVD STE 300
Jacksonville, FL 32223
  • Reassigned Medicare billing, Florida enrollment
  • 321 clinicians in this Medicare group
NPI 1912953290 (904) 396-1725

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 6

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This 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.
56 services56 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.
50 services42 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.
25 services25 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.
23 services21 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
15 services11 patients
Repair of groin hernia using an endoscope 49650
This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32207 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

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.

79.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.47
Promoting Interoperability96
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
30%109 patients2/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
41%150 patients2/55-star benchmark: 100%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
2%108 patients
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%785 patients5/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
84%104 patients4/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%200 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
41%578 patients2/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
50%319 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 94% · 180 patients
84%58 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%578 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
2%578 patients1/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 139 patients
0%139 patients5/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
31%578 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

REPRODUCTIVE MEDICINE ASSOCIATES, P.A.
Obstetrics & Gynecology (Reproductive Endocrinology)
836 PRUDENTIAL DR, SUITE 902
JACKSONVILLE, FL 32207
Duval County (904) 399-5620
HECTOR EDWARD JAMES MD
Neurological Surgery
836 PRUDENTIAL DR, UFJP NEUROSURGERY - PEDIATRICS
JACKSONVILLE, FL 32207
Duval County (904) 398-5201
DR. ALAN RONALD ECKELS M.D.
Specialist
836 PRUDENTIAL DR, SUITE 1606
JACKSONVILLE, FL 32207
Duval County (904) 396-3700
ERIN M MOORE MD
Surgery (Vascular Surgery)
836 PRUDENTIAL DR, STE 1804
JACKSONVILLE, FL 32207
Duval County (904) 398-3888
HAYDEN POTTER APRN
Nurse Practitioner (Family)
836 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 000-0000
JOSEPH DAVID ALLEN PA-C
Physician Assistant (Medical)
836 PRUDENTIAL DR, SUITE 801
JACKSONVILLE, FL 32207
Duval County (904) 288-0433
JEFFREY D RICKETTS PA
Physician Assistant (Surgical)
836 PRUDENTIAL DR, STE 1804
JACKSONVILLE, FL 32207
Duval County (904) 398-3888
ALEXANDER TUAN ROSE M.D.
Surgery
836 PRUDENTIAL DR, SUITE 1001
JACKSONVILLE, FL 32207
Duval County (904) 398-0033

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 Gordon Polley's NPI number?

The NPI number for Gordon Polley is 1265490056. It was assigned to this individual provider in the NPPES registry on May 2, 2006.

Where is Gordon Polley located?

Gordon Polley practices at 836 Prudential Dr Suite 1001, Jacksonville, FL 32207. The listed phone number is (904) 398-0033.

What is Gordon Polley's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Gordon Polley enrolled in Medicare?

Yes. Gordon Polley is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Gordon Polley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gordon Polley reassigns Medicare benefits to North Florida Surgeons, PA (Jacksonville, FL). 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 Gordon Polley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gordon Polley accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare and UnitedHealthcare list Gordon Polley 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.

When was this NPI record last updated?

The NPPES record for Gordon Polley was last updated on July 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.