DR. JOHN WILLIAM POLLEY M.D.
NPI 1477534931
Plastic Surgery in Traverse City, MI
About Dr. John William Polley M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JOHN WILLIAM POLLEY M.D. (NPI 1477534931) is an individual plastic surgery provider in Traverse City, Michigan, licensed in Michigan (4301403808) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Grand Rapids.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Other Identifiers 3
Accepted 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. John William Polley M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show John Polley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Traverse City, MI 49684
- Reassigned Medicare billing, Michigan enrollment
- 492 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49684 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 John Polley's NPI number?
The NPI number for John Polley is 1477534931. It was assigned to this individual provider in the NPPES registry on November 10, 2005. The provider is also known as Dr. John William Polley M.D..
Where is John Polley located?
John Polley practices at 5085 Anna Dr Ste A, Traverse City, MI 49684. The listed phone number is (231) 935-0180.
What is John Polley's specialty?
The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.
Is John Polley enrolled in Medicare?
Yes. John Polley is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for John Polley's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Polley reassigns Medicare benefits to Munson Medical Center (Traverse City, MI). 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 John Polley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does John Polley accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Montana, PacificSource Health Plans and Priority Health and 1 other insurer list John 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 John Polley was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Dr. John William Polley, M.D. · NPI 1477534931
Plastic Surgery physician in Traverse City, Michigan. Individual provider, active in the CMS NPPES registry since November 10, 2005.
## Identity
- **NPI:** 1477534931 (Entity type: Individual)
- **Enumerated:** November 10, 2005
- **Primary specialty:** Plastic Surgery · taxonomy 208200000X
- **State license:** 4301403808 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 5085 ANNA DR STE A, Traverse City, MI 49684-7475
- **Phone:** (231) 935-0180 · **Fax:** (231) 935-0099
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Munson Medical Center (NPI 1568002004, Traverse City, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 7, 2023
- **Other identifiers:** Medicaid 036079739 (IL); Other 0B80405 (MI); Other 21623004 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1477534931) · Data from the CMS NPPES public registry.