ALEX JOHN POLENICK (PA-C) – Medical Physician Assistant, NPI 1003397654
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for ALEX JOHN POLENICK (PA-C)
6470 TIPPECANOE ROAD
CANFIELD, OH 444067036
Phone: (330) 758-0577
Fax: (330) 758-0466
Type: Mailing
1695 Niles Cortland Rd NE
Warren, OH 444841165
Phone: (330) 758-0577
Type: Location
Boardman Canfield Road, Boardman Plaza, Boardman, Mahoning County, Ohio, 44512, United States
BOARDMAN, OH 445124008
Phone: (330) 758-0577
Fax: (330) 533-4587
Type: Location
8591 CROSSROADS DRIVE
YOUNGSTOWN, OH 44514
Phone: (330) 758-0577
Fax: (330) 758-0466
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: 2018-09-06
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 |
|---|---|---|---|---|
| I20180906002315 | I | Physician Assistant | OH | 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 |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 773 | 121 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 239 | 220 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 110 | 103 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 109 | 109 | $0 |
| 73562 | X-ray of knee, 3 views | 109 | 107 | $0 |
Insurance plans in this area (ZIP 44406)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | OH | |
| P O D I A T R Y | IL | |
| Occupational Therapist In Private Practice | OH | |
| Physical Therapist In Private Practice | OH | |
| Physical Therapist In Private Practice | OH | |
| Orthopedic Surgery | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| P O D I A T R Y | OH | |
| Orthopedic Surgery | OH |
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