DR. JOHN WILLIAM POLLEY M.D.
NPI 1477534931
Plastic Surgery in Traverse City, MI

Q: 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..

Q: What is John Polley's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Q: 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.

Active since November 10, 2005PECOS Enrolled

100/100

CMS Quality Rating

5085 ANNA DR STE A, TRAVERSE CITY, MI 49684(231) 935-0180(231) 935-0099 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 7, 2023, Jan 17, 2022, Nov 18, 2021 and 3 more (6 updates tracked since 2017).

On this page

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

NPI1477534931

Entity TypeIndividualMale

Primary Taxonomy208200000X

Provider Legal NameDR. JOHN WILLIAM POLLEYCredential: M.D.

Location Address5085 ANNA DR STE ATraverse City, MI 49684-7475

Mailing Address5085 Anna Dr Ste ATraverse City, MI 49684-7475 · (231) 935-0180 · Fax (231) 935-0099

Phone(231) 935-0180

Fax(231) 935-0099

Sole ProprietorNo

Enumeration DateNovember 10, 2005

Last NPPES UpdateMarch 7, 20236 updates tracked since enumeration

NPPES CertifiedJanuary 17, 2022

✔ NPI 1477534931 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208200000X

License✔ Licensed in MI · 4301403808

Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

5085 ANNA DR STE A, Traverse City, MI 49684

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Other Names 1

Professional Name (2)Dr. John William Polley M.d.

Secondary Practice Location 1

Location 135 Michigan St NE Ste 5201Grand Rapids, MI 49503-2514 · Phone (616) 486-5885 · Fax (616) 391-1191

Other Identifiers 3

Medicaid036079739IL

Other0B80405MI · Bcbsmi

Other21623004IL · Bcbs Provider #

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross and Blue Shield of Montana, Blue Cross Blue Shield of Michigan Mutual Insurance Company 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. John William 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.

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.

New Patient

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

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.

F MATTHEW SMITH MD

Plastic Surgery

5085 ANNA DR STE A
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 935-0180

ABIGAIL ELIZABETH BOBBITT PA-C

Physician Assistant

5085 ANNA DR STE A
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 935-0180

MEGAN VANDERKAAY PA

Physician Assistant

5085 ANNA DR STE A
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 935-0180

MUNSON MEDICAL CENTER

Plastic Surgery

5085 ANNA DR STE A
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 935-0180

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.

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, McLaren Health Plan Community and Priority Health 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.