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CRYSTABEL POLANCO M.D.
NPI 1922529296
Pediatrics in Passaic, NJ

Active since June 27, 2017PECOS Enrolled
63 CENTRAL AVE, PASSAIC, NJ 07055(973) 574-8688 Get Directions Write a Review

NPPES record last updated: January 25, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 25, 2022, Apr 24, 2020, Apr 1, 2020 and 1 more (4 updates tracked since 2017).

About Crystabel Polanco M.d. NPPES

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

CRYSTABEL POLANCO M.D. (NPI 1922529296) is an individual pediatrics provider in Passaic, New Jersey, licensed in New Jersey (25MA10855800) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1922529296
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameCRYSTABEL POLANCOCredential: M.D.
Location Address63 CENTRAL AVEPassaic, NJ 07055-8406
Mailing Address1 Pauline DrNutley, NJ 07110-3123 · (862) 621-5883
Phone(973) 574-8688
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJune 27, 2017
Last NPPES UpdateJanuary 25, 20224 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2022
✔ NPI 1922529296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NJ · 25MA10855800
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
63 CENTRAL AVE, Passaic, NJ 07055
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crystabel Polanco M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951874924
PECOS Enrollment IDI20260622004064
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 Crystabel Polanco reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Josephs Medical Group PC
3.0 mi
Internal Medicine
703 MAIN ST
Paterson, NJ 07503
  • Reassigned Medicare billing, New Jersey enrollment
  • 317 clinicians in this Medicare group
NPI 1205425519 (973) 754-2000

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 07055 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Crystabel Polanco's NPI number?

The NPI number for Crystabel Polanco is 1922529296. It was assigned to this individual provider in the NPPES registry on June 27, 2017.

Where is Crystabel Polanco located?

Crystabel Polanco practices at 63 Central Ave, Passaic, NJ 07055. The listed phone number is (973) 574-8688.

What is Crystabel Polanco's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Crystabel Polanco enrolled in Medicare?

Yes. Crystabel Polanco is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Crystabel Polanco's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Crystabel Polanco reassigns Medicare benefits to St Josephs Medical Group PC (Paterson, NJ). 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 Crystabel Polanco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Crystabel Polanco accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Crystabel Polanco 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 Crystabel Polanco was last updated on January 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.