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MICHAEL J POLSKI MD PA
NPI 1417233586
Family Medicine in Burleson, TX

Active since November 02, 2011CLIA 45D0903162 · Microscopy
1310 NW JOHN JONES DR, BURLESON, TX 76028(817) 297-1297(817) 297-6363 Get Directions Write a Review

NPPES record last updated: November 2, 2011. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Michael J Polski Md Pa NPPES

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

MICHAEL J POLSKI MD PA (NPI 1417233586) is a healthcare organization registered as a family medicine in Burleson, Texas and active in the NPI registry since November 2011. The organization holds a CLIA Microscopy certificate valid through July 12, 2027 and lists Michael J Polski, Ceo/owner, as its authorized official.

NPPES Registry Identity

NPI1417233586
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMICHAEL J POLSKI MD PA
Location Address1310 NW JOHN JONES DRBurleson, TX 76028-8040
Mailing Address1310 Nw John Jones DrBurleson, TX 76028-8040 · (817) 297-1297 · Fax (817) 297-6363
Phone(817) 297-1297
Fax(817) 297-6363
Organization SubpartNo
Authorized OfficialMichael J PolskiCeo/owner · (817) 297-1297
Enumeration DateNovember 2, 2011
✔ NPI 1417233586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · H9592
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1310 NW JOHN JONES DR, Burleson, TX 76028
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Other Identifiers 3

Medicare UPINE91006TX
Medicaid139817420TX
Medicaid139817405TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael J Polski Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Michael J Polski MD PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Michael Polski, M.D.
Emergency Medicine
NPI 1952342487
1310 NW JOHN JONES DR
Burleson, TX 76028
(817) 297-1297
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 45D0903162

Michael J Polski MD PA · Burleson, TX
Active · expires Jul 12, 2027
CLIA Number45D0903162
Laboratory TypePhysician Office
Certificate Effective DateJuly 13, 2025
Certificate Expiration DateJuly 12, 2027
Laboratory DirectorMichael J. Polski MD
Laboratory Phone(817) 297-1297
Laboratory LocationMichael J Polski MD PA1310 NW John Jones Dr, Burleson, TX 76028
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Michael J Polski MD PA's NPI number?

The NPI number for Michael J Polski MD PA is 1417233586. It was assigned to this organization in the NPPES registry on November 2, 2011.

Where is Michael J Polski MD PA located?

Michael J Polski MD PA is located at 1310 NW John Jones Dr, Burleson, TX 76028. The listed phone number is (817) 297-1297.

What is Michael J Polski MD PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Michael J Polski MD PA enrolled in Medicare?

Yes. Michael J Polski MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Michael J Polski MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Emergency Medicine) reassigns their Medicare billing to Michael J Polski MD PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Michael J Polski MD PA hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D0903162) is associated with this NPI, valid through July 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Michael J Polski MD PA was last updated on November 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.