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DR. ADAM CHARLES POLIVY D.M.D.
NPI 1447562426
Dentist - General Practice in Boston, MA

Active since July 07, 2010PECOS Enrolled
100 E NEWTON ST, ROOM G-401, BOSTON, MA 02118(617) 638-4705 Get Directions Write a Review

NPPES record last updated: July 7, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Adam Charles Polivy D.m.d. NPPES

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

DR. ADAM CHARLES POLIVY D.M.D. (NPI 1447562426) is an individual general practice provider in Boston, Massachusetts, licensed in Massachusetts (DL10956) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1447562426
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. ADAM CHARLES POLIVYCredential: D.M.D.
Location Address100 E NEWTON ST, ROOM G-401Boston, MA 02118-2308
Mailing Address100 E Newton St, Room G-401Boston, MA 02118-2308 · (617) 638-4705
Phone(617) 638-4705
Sole ProprietorNo
Enumeration DateJuly 7, 2010
✔ NPI 1447562426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MA · DL10956
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

100 E NEWTON ST, Boston, MA 02118
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Adam Charles Polivy D.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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02118 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.

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.

THITAYA CHAIBOONYARAK
Student in an Organized Health Care Education/Training Program
100 E NEWTON ST
BOSTON, MA 02118
Suffolk County (617) 358-8300
JOHN ICTECH-CASSIS
Dentist (Prosthodontics)
100 E NEWTON ST, G-716
BOSTON, MA 02118
Suffolk County (617) 638-5225
TRUSTEES OF BOSTON UNIVERSITY
Dentist (General Practice)
100 E NEWTON ST, ROOM G401
BOSTON, MA 02118
Suffolk County (617) 638-4993
JARED CURTIN
Dentist (Oral and Maxillofacial Surgery)
100 E NEWTON ST, G305
BOSTON, MA 02118
Suffolk County (508) 328-5656
GHADIR ATOUT HAJHAMAD
Dentist (Periodontics)
100 E NEWTON ST, 107
BOSTON, MA 02118
Suffolk County (617) 638-4758
WEN-TSE LIN DMD
Dentist (Periodontics)
100 E NEWTON ST
BOSTON, MA 02118
Suffolk County (617) 638-4700
DR. GHADEER I BASUNBUL BDS
Dentist (Prosthodontics)
100 E NEWTON ST, RM G-401
BOSTON, MA 02118
Suffolk County (617) 638-4705
DR. BASIL ANDIJANI BDS
Student in an Organized Health Care Education/Training Program
100 E NEWTON ST
BOSTON, MA 02118
Suffolk County (617) 638-4683

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 Adam Polivy's NPI number?

The NPI number for Adam Polivy is 1447562426. It was assigned to this individual provider in the NPPES registry on July 7, 2010.

Where is Adam Polivy located?

Adam Polivy practices at 100 E Newton St Room G-401, Boston, MA 02118. The listed phone number is (617) 638-4705.

What is Adam Polivy's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Adam Polivy enrolled in Medicare?

Yes. Adam Polivy is registered in the Medicare PECOS enrollment system.

What insurance does Adam Polivy accept?

Health plans from Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Adam 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.

When was this NPI record last updated?

The NPPES record for Adam Polivy was last updated on July 7, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.