RACHAEL MARIE POLAK (ACNP) – Gerontology Nurse Practitioner, NPI 1346882974

RACHAEL MARIE POLAK (ACNP) is a healthcare provider. based in Lubbock, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials ACNP. They hold a License No. 856862 (TX). The NPI Number for RACHAEL MARIE POLAK (ACNP) is 1346882974

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
RACHAEL MARIE POLAK (ACNP)
NPI
1346882974
Phone
(806) 794-8484
Address
3621 22ND ST STE 400
Enumeration Date
15 October 2019
Last Update Date
5 May 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9372987751
Graduation Year
2019 (7 years ago)
PAC ID
9234563420
Group Practice PAC ID
3173710936
Professional Enrollment ID
I20220408001334
Address ID
OH454292405KE4441XAVEX400

Contacts

Secure Messaging
rpolak788965@direct.ketteringhealth.org
FHIR Endpoint
https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness85
Years active:6State licenses:2Other namesUpdated within 12 months

22,204 NURSE PRACTITIONER in TX

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Provider Addresses for RACHAEL MARIE POLAK (ACNP)

  • 22nd Street, Tech Terrace U.N.I.T., Lubbock, Lubbock County, Texas, 79410, United States

    LUBBOCK, TX 794101302

    Phone: (806) 794-8484

    Type: Location

  • 2215, Nashville Avenue, Maedgen, Lubbock, Lubbock County, Texas, 79410, United States

    LUBBOCK, TX 794101105

    Phone: (806) 725-5844

    Type: Mailing

  • 1 PRESTIGE PL STE 550

    MIAMISBURG, OH 453426115

    Phone: (937) 762-1305

    Fax: (937) 522-7513

    Type: Mailing

  • 405 W GRAND AVE

    DAYTON, OH 454057538

    Phone: (937) 723-3841

    Fax: (937) 723-4209

    Type: Location

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: 2022-04-08

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
I20220408001334INurse PractitionerOHTBD

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 79410)

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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: 3173710936View full group profile
NameSpecialtyState
Geriatric Medicine, Hematology/OncologyIL
Nurse PractitionerOH
Hematology/Oncology, Internal MedicineOH
Radiation OncologyOH
Nurse PractitionerOH
O B S T E T R I C S/ G Y N E C O L O G YOH
Orthopedic SurgeryOH
Pulmonary Disease, Critical Care (Intensivists), Sleep MedicineOH
Physician AssistantOH
Hospitalist, Emergency MedicineOH

Reviews

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Frequently asked questions

How is RACHAEL MARIE POLAK (ACNP) identified in CMS data?
CMS-hosted NPPES data lists RACHAEL MARIE POLAK (ACNP) with NPI 1346882974.
Can I rely on RACHAEL MARIE POLAK (ACNP) being an active provider?
As of the registry snapshot, RACHAEL MARIE POLAK (ACNP) is marked active.
What is RACHAEL MARIE POLAK (ACNP) best known for clinically?
Directory data describes RACHAEL MARIE POLAK (ACNP) with Gerontology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does RACHAEL MARIE POLAK (ACNP) list a practice location?
Patients near Lubbock, Texas may find RACHAEL MARIE POLAK (ACNP) in results; validate coverage separately.
Is the information about RACHAEL MARIE POLAK (ACNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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