MIKA POLLY (FNP) – Family Nurse Practitioner, NPI 1417326547

MIKA POLLY (FNP) is a healthcare provider. based in Lubbock, Texas. specializing in Family Nurse Practitioner. They hold the professional credentials FNP. They hold a License No. AP129050 (TX). The NPI Number for MIKA POLLY (FNP) is 1417326547

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MIKA POLLY (FNP)
NPI
1417326547
Phone
(806) 788-0040
Address
4802 N LOOP 289
Enumeration Date
18 September 2015
Last Update Date
8 September 2017

Doctor Profile

Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Secondary Phone
8067880040
Graduation Year
2015 (11 years ago)
PAC ID
6709195480
Group Practice PAC ID
0042476582
Professional Enrollment ID
I20151020001419
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for MIKA POLLY (FNP)

  • 4802 N LOOP 289

    LUBBOCK, TX 794163025

    Phone: (806) 788-0040

    Fax: (806) 788-0015

    Type: Mailing

  • 4642 N LOOP 289

    STE 211

    LUBBOCK, TX 794162425

    Phone: (806) 712-9007

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 42 Open Payments records for all available years, with a total value of $670.

Total Amount is formed as General ($670) + Research ($0) + Ownership ($0) = $670.

Last reported payment date: 2024-11-11 • Largest payer in this snapshot: Amgen Inc. ($255).

Total Amount

$670

General + Research + Ownership

Payments

42

Total payment records

General Amount

$670

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-11

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2015-10-20

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
I20151020001419INurse PractitionerTXTBD

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 79416)

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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: 0042476582View full group profile
NameSpecialtyState
Physician AssistantTX
-TX
Cardiovascular Disease (Cardiology)TX
Family Practice, Emergency MedicineTX
Internal MedicineNM
Cardiovascular Disease (Cardiology)TX
Cardiovascular Disease (Cardiology)TX
Cardiovascular Disease (Cardiology)TX
Cardiovascular Disease (Cardiology), Cardiac Electrophysiology, Internal MedicineTX

Reviews

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Frequently asked questions

How is MIKA POLLY (FNP) identified in CMS data?
CMS-hosted NPPES data lists MIKA POLLY (FNP) with NPI 1417326547.
Is MIKA POLLY (FNP) listed as active for patients and plans?
The listing shows MIKA POLLY (FNP) as active in the NPI system.
What healthcare role does MIKA POLLY (FNP) hold?
Scheduling teams often label MIKA POLLY (FNP) under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MIKA POLLY (FNP) based?
MIKA POLLY (FNP) is tied to Lubbock, Texas in the data we show; additional addresses may exist on the full record.
Why does MIKA POLLY (FNP) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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