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

Individual provider Orthopaedic Surgery Physician · NPI 1194794115

Kenneth D Polivy, MD is an Orthopedic Surgery in Newton, Massachusetts. Graduated from Tufts University School of Medicine in 1978, 48 years ago. Practices with Newton Wellesley Orthopedic Associates Inc, a 26-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
48
Trained at
Tufts University School of Medicine
Licensed in
MA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2000 Washington St Ste 341
Newton, MA 02462-1650
Phone: (617) 964-0024
Fax: (617) 964-6374
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 47345 (MA)

Record details

NPI number1194794115
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 14, 2006
Last updated in NPPESNovember 1, 2011
Mailing address2000 Washington St, Suite 341, Newton, MA 02462-1650

Medicare enrollment

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

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolTUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1978 (48 years in practice)
Group practice Newton Wellesley Orthopedic Associates Inc — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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