AUSTIN POLUTANOVICH – Acute Care Nurse Practitioner, NPI 1871339820

AUSTIN POLUTANOVICH is a healthcare provider. based in West bloomfield, Michigan. specializing in NURSE PRACTITIONER. They hold a License No. 4704341665 (MI). The NPI Number for AUSTIN POLUTANOVICH is 1871339820

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
AUSTIN POLUTANOVICH
NPI
1871339820
Phone
(248) 661-6466
Address
6777 W MAPLE RD
Enumeration Date
8 July 2024
Last Update Date
19 January 2026

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
8102759333116
Graduation Year
2024 (2 years ago)
PAC ID
2860930450
Group Practice PAC ID
5799779633
Professional Enrollment ID
I20240814001328
Address ID
MI481262749DE5111XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for AUSTIN POLUTANOVICH

  • 6777 W MAPLE RD

    WEST BLOOMFIELD, MI 483223013

    Phone: (248) 661-6466

    Type: Location

  • 1092 OREGON BLVD

    WATERFORD, MI 483273345

    Phone: (810) 394-1334

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-08-14

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240814001328INurse PractitionerMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48322)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799779633View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeMI
General SurgeryTX
Nurse PractitionerMI
A N E S T H E S I O L O G YMI
Orthopedic SurgeryMI
Nurse PractitionerMI
Interventional Radiology, Vascular SurgeryCT
Clinical PsychologistMI
Diagnostic RadiologyFL
Nurse PractitionerMI

Reviews

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Frequently asked questions

What federal number belongs to AUSTIN POLUTANOVICH?
The federal identifier for AUSTIN POLUTANOVICH is NPI 1871339820.
Is AUSTIN POLUTANOVICH currently active in the NPI registry?
CMS-published data lists AUSTIN POLUTANOVICH as an active registrant.
What kind of provider is AUSTIN POLUTANOVICH?
The page reflects Acute Care Nurse Practitioner for AUSTIN POLUTANOVICH. Clinical services aligned with this taxonomy classification.
What location metadata exists for AUSTIN POLUTANOVICH?
The page summarizes West Bloomfield, Michigan for AUSTIN POLUTANOVICH; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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