DORISA L POLK (MD) – Obstetrics & Gynecology Physician, NPI 1205833027
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
270 OBSTETRICS/GYNECOLOGY in NE
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Provider Addresses for DORISA L POLK (MD)
3911, Avenue B, Scottsbluff, Scotts Bluff County, Nebraska, 69361, United States
STE 3100
SCOTTSBLUFF, NE 693614617
Phone: (308) 635-3033
Fax: (308) 635-3010
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $2,208.
Total Amount is formed as General ($2,208) + Research ($0) + Ownership ($0) = $2,208.
Last reported payment date: 2024-10-28 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($2,000).
Total Amount
$2,208
General + Research + Ownership
Payments
13
Total payment records
General Amount
$2,208
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $2,000 |
| Bayer Healthcare Pharmaceuticals Inc. | $109 |
| Organon LLC | $34 |
| ABBVIE INC. | $26 |
| Merck Sharp & Dohme LLC | $20 |
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: 2004-12-09
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 |
|---|---|---|---|---|
| I20041209000741 | I | Obstetrics/Gynecology | NE | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 120 | 87 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 85 | 60 | $0 |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | 48 | 48 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 38 | 38 | $0 |
| 76830 | Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | 18 | 17 | $0 |
Insurance plans in this area (ZIP 69361)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | NE | |
| Physical Medicine And Rehabilitation, Pain Management | NE | |
| Family Practice | NE | |
| - | NE | |
| Physician Assistant | AZ | |
| - | NE | |
| Internal Medicine, Medical Oncology, Medical Oncology, Hematology, Hematology/Oncology, Internal Medicine | TX | |
| Family Practice | NE | |
| H E M A T O L O G Y/ O N C O L O G Y | CO | |
| - | CO |
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