Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1477534931 Individual Practitioner Male Practitioner

Dr. John William Polley , MD

Plastic Surgery • Traverse City, MI

Professional Overview & Biography Verified Profile Summary

Dr. John Polley, MD is a registered healthcare professional specializing in Plastic Surgery in Traverse City, MI. Practice services are available at 5085 ANNA DR STE A under active NPI credentials.

Frequently performed procedures and clinical services include new patient outpatient office visit, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

5085 Anna Dr Ste A

Traverse City, MI 496847475

Telephone 2319350180
Fax 2319350099
Associated Practice Facility / Clinic
🏢 Munson Medical Center Facility NPI 1992463566

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Traverse City, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 24.8 Yrs
State Avg: 28.5 Yrs
Regional Practice Density
7 Specialists

Practicing in Traverse City, MI (186 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
39.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
14 13 $179.00 $108.83

Medical Specialties & State Licenses

CMS Verified: 2022-01-17
Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

State License MI 4301403808

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
036079739 (IL)
Commercial Insurance / Payer ID Bcbsmi
0B80405 (MI)
Commercial Insurance / Payer ID Bcbs Provider #
21623004 (IL)

Secondary Practice Locations

35 Michigan St Ne Ste 5201

Grand Rapids, MI 495032514

Phone: 6164865885

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. F Smith , MD

Plastic Surgery

NPI 1285614032

Doctor of Medicine (M.D.)

Abigail Bobbitt , PA-C

Physician Assistant

NPI 1356809883

Physician Assistant (Certified)

Megan Vanderkaay , PA

Physician Assistant

NPI 1770279366

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location January 17, 2022

Registered at 5085 ANNA DR STE A, TRAVERSE CITY, MI 496847475 (Tel: 2319350180)

📍
Updated Business Mailing Address January 17, 2022

Registered at 5085 ANNA DR STE A, TRAVERSE CITY, MI 496847475 (Tel: 2319350180)

NPI Profile Active August 01, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location August 01, 2017

Registered at 35 MICHIGAN ST NE STE 5201, GRAND RAPIDS, MI 495032514 (Tel: 6164865885)

📍
Updated Business Mailing Address August 01, 2017

Registered at 100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 495032560

👤
Provider Name / Credentials Updated August 01, 2017

Recorded as JOHN POLLEY, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 01, 2017

Plastic Surgery (License #4301403808 in MI)

NPI Profile Active December 07, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location December 07, 2016

Registered at 3529 W FRONT ST, JP CENTER FOR PLASTIC SURGERY, TRAVERSE CITY, MI 496847484 (Tel: 2313461047)

📍
Updated Business Mailing Address December 07, 2016

Registered at 3529 W FRONT ST, JP CENTER FOR PLASTIC SURGERY, TRAVERSE CITY, MI 496847484 (Tel: 2313461047)

👤
Provider Name / Credentials Updated December 07, 2016

Recorded as JOHN POLLEY, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 07, 2016

Specialist

🟢
Initial NPI Registration & Enumeration November 10, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477534931
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 10, 2005
Last Update: March 07, 2023
Sole Proprietor: No

Mailing Address

5085 Anna Dr Ste A

Traverse City, MI 496847475

Phone: 2319350180

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.