JUAN POLANCO (PA-C) – Physician Assistant, NPI 1992117311
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JUAN POLANCO (PA-C)
141 E MAIN ST STE 420
PULASKI, VA 243015085
Phone: (704) 604-8488
Type: Mailing
17553 GLENAPP DR
LAND O LAKES, FL 346387834
Phone: (704) 604-8488
Type: Mailing
2114 SEVEN SPRINGS BLVD
TRINITY, FL 346553908
Phone: (352) 518-2000
Fax: (352) 567-5193
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 53 Open Payments records for all available years, with a total value of $1,055.
Total Amount is formed as General ($1,055) + Research ($0) + Ownership ($0) = $1,055.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Lilly USA, LLC ($220).
Total Amount
$1,055
General + Research + Ownership
Payments
53
Total payment records
General Amount
$1,055
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $220 |
| Novo Nordisk Inc | $115 |
| ABBVIE INC. | $110 |
| Orthofix Medical, Inc. | $85 |
| Exact Sciences Corporation | $68 |
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: 2021-09-27
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 |
|---|---|---|---|---|
| I20210927003340 | I | Physician Assistant | FL | 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 24301)
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Reviews
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