MS. MARIA VICTORIA POLANCO (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1467439455
Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
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Provider Addresses for MS. MARIA VICTORIA POLANCO (PHYSICIAN ASSISTANT)
Saint Francis Avenue, Shakopee, Scott County, Minnesota, 55379, United States
SHAKOPEE, MN 553793374
Phone: (952) 993-7750
Type: Location
Wayzata Blvd, South Wayzata Boulevard, Minneapolis, Hennepin County, Minnesota, 55416, United States
STE 315
MINNEAPOLIS, MN 554261728
Phone:
Type: Mailing
1415 Saint Francis Ave
Shakopee, MN 553793374
Phone: (952) 993-7750
Type: Location
1601 SAINT FRANCIS AVE STE 100
SHAKOPEE, MN 553793384
Phone: (952) 428-3535
Fax: (952) 428-3599
Type: Location
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 554254516
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $100.
Total Amount is formed as General ($100) + Research ($0) + Ownership ($0) = $100.
Last reported payment date: 2024-07-16 • Largest payer in this snapshot: Itamar Medical Inc ($42).
Total Amount
$100
General + Research + Ownership
Payments
5
Total payment records
General Amount
$100
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Itamar Medical Inc | $42 |
| Dexcom, Inc. | $21 |
| Lilly USA, LLC | $19 |
| Medtronic, Inc. | $18 |
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: 2010-01-22
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 |
|---|---|---|---|---|
| I20100122000339 | I | Physician Assistant | MN | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55379)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | CO | |
| Qualified Audiologist | MN | |
| Family Practice | MN | |
| - | MN | |
| Family Practice | MN | |
| Nurse Practitioner | ND | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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