NPI Portal NPI Lookup & Verification

Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Dr. Donovan C Polack, MD

Nephrology Physician in Florissant, MO · enumerated 2006 · practices at St Louis Kidney Care LLC.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1659324465

Verified

See something wrong? Report a correction

Registry record

Entity type Individual (Type 1)
Name Dr. Donovan C Polack
Credential MD
Sex Male
Practice address 1265 Graham Rd Ste 1, Florissant, MO, 63031
Phone (314) 741-1600
Fax (314) 741-1677
Enumeration date May 19, 2006
Last updated in NPPES May 22, 2024

Taxonomy & licenses

174400000X Specialist Other Service Providers · License 036-072078 (IL) Secondary
174400000X Specialist Other Service Providers · License R5H69 (MO) Secondary
207RN0300X Nephrology Physician Allopathic & Osteopathic Physicians · License 036-072078 (IL) Secondary
207RN0300X Nephrology Physician Allopathic & Osteopathic Physicians · License R5H69 (MO) Primary
MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier Type State Issuer
036072078 Medicaid IL -
202546321 Medicaid MO -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where does Donovan Polack practice?
The practice location on file with NPPES is in Florissant, MO. Providers can have multiple locations; NPPES lists the primary practice address.
What is the NPI number for Donovan Polack?
The National Provider Identifier (NPI) for Donovan Polack is 1659324465, a Type 1 (individual) record in the CMS NPPES registry.

Other providers at this practice address

Browse all →

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-05-22.