Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gustavo Emil Polanco Hernandez, PA

Individual provider Critical Care Medicine (Internal Medicine) Physician · NPI 1013558188

Gustavo Emil Polanco Hernandez, PA is a Physician Assistant in Bronx, New York. Qualified in 2019, 7 years ago. Practices with Shakespeare Operating LLC, a 137-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida and New York.

Years since qualifying
7
Licensed in
FL, NY
In the registry since
2019
Specialties on file
6
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2015 Grand Concourse
Bronx, NY 10453-4303
Phone: (718) 583-7736
Fax: (718) 537-6180
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 029357 (NY)
Critical Care Medicine (Internal Medicine) Physician Taxonomy 207RC0200X · Licence PA9112633 (FL)
Psychiatry Physician Taxonomy 2084P0800X · Licence PA9112633 (FL)
Physician Assistant Taxonomy 363A00000X · Licence PA9112633 (FL)
Neurological Surgery Physician Taxonomy 207T00000X · Licence PA9112633 (FL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA9112633 (FL)

Record details

NPI number1013558188
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 30, 2019
Last updated in NPPESJanuary 12, 2023
Certification dateJanuary 12, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Shakespeare Operating Llc — 137 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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