GUSTAVO EMIL POLANCO HERNANDEZ (PA) – Physician Assistant, NPI 1013558188
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
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Provider Addresses for GUSTAVO EMIL POLANCO HERNANDEZ (PA)
8455 NW 189TH LN APT 1506
HIALEAH, FL 330157239
Phone: (786) 317-0766
Type: Mailing
Jackson Memorial Hospital, 1611, Northwest 12th Avenue, Miami, Miami-Dade County, Florida, 33136, United States
MIAMI, FL 331361005
Phone: (305) 585-1111
Type: Location
6120 REESE RD APT 307
DAVIE, FL 333141258
Phone: (786) 317-0766
Type: Mailing
2950 CLEVELAND CLINIC BLVD
WESTON, FL 333313609
Phone: (954) 659-5000
Type: Location
2626 HALPERIN AVE
BRONX, NY 104612631
Phone: (718) 618-0401
Fax: (347) 479-1303
Type: Mailing
2015 GRAND CONCOURSE
BRONX, NY 104534303
Phone: (718) 583-7736
Fax: (718) 537-6180
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $975.
Total Amount is formed as General ($975) + Research ($0) + Ownership ($0) = $975.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: ViiV Healthcare Company ($370).
Total Amount
$975
General + Research + Ownership
Payments
22
Total payment records
General Amount
$975
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ViiV Healthcare Company | $370 |
| Lilly USA, LLC | $201 |
| GlaxoSmithKline, LLC. | $175 |
| Bayer Healthcare Pharmaceuticals Inc. | $125 |
| ABBVIE INC. | $41 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-01-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230104002646 | I | Physician Assistant | NY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 135 | 40 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 113 | 91 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 18 | 14 | $0 |
Insurance plans in this area (ZIP 33015)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NY | |
| Physical Therapist In Private Practice | NY | |
| Physician Assistant | NY | |
| Clinical Social Worker | NY | |
| Clinical Psychologist | NY | |
| Nurse Practitioner | NY | |
| Internal Medicine, Hematology/Oncology | NY | |
| Clinical Social Worker | NY | |
| Clinical Social Worker | NJ | |
| Hematology/Oncology, Internal Medicine | NY |
Reviews
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