POLARIS SURBERY CENTER
NPI 1649456021
Clinic/Center - Ambulatory Surgical in Westerville, OH

NPI Status: Active since January 15, 2008

Contact Information

300 POLARIS PKWY
SUITE 110
WESTERVILLE, OH
ZIP 43082
Phone: (614) 566-0568
Fax: (614) 566-0608

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 36D1085878
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 06-29-2026

About POLARIS SURBERY CENTER

This page provides the complete NPI Profile along with additional information for Polaris Surbery Center, a provider established in Westerville, Ohio operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1649456021 assigned on January 2008. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Polaris Surbery Center. The authorized official of this NPI record is Mr. Steven J. Bultema (Administrator)

NPI
1649456021
Provider Legal Name
POLARIS SURGERY CENTER, LLC
Other Organization Name
POLARIS SURBERY CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
300 POLARIS PKWY SUITE 110 WESTERVILLE, OH 43082
Location Phone
(614) 566-0568
Location Fax
(614) 566-0608
Mailing Address
300 POLARIS PKWY SUITE 110 WESTERVILLE, OH 43082
Mailing Phone
(614) 566-0568
Mailing Fax
(614) 566-0608
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-15-2008
Last Update Date
01-15-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision - HMO
  • Anthem Bronze Pathway HMO 7450 for HSA - HMO
  • Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Catastrophic Pathway HMO 9200 - HMO
  • Anthem Gold Pathway HMO 1500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Pathway HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Silver Pathway X HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway HMO 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway HMO 5000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway HMO 5400 for HSA - HMO
  • Anthem Silver Pathway X HMO 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
  • Bronze HSA $7,300 ON-EX - HMO
  • Bronze Standard w/ Virtual & Wellness - HMO
  • Gold $1250 w/ Virtual & Wellness ON-EX - HMO
  • Gold $500 w/ Virtual & Wellness ON-EX - HMO
  • Gold Standard w/ Virtual & Wellness - HMO
  • Silver $5000 w/ Virtual & Wellness ON-EX - HMO
  • Silver Standard w/ Virtual & Wellness - HMO
  • SilverSelect w/ Virtual & Wellness ON-EX - HMO
  • Young Adult Essentials ON-EX - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. STEVEN J. BULTEMA

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(614) 566-0568

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 20 times for 14 patients

Aspiration and/or injection of fluid from medium joint

This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.

This service was performed 20 times for 15 patients

Correction of toe joint deformity

Correction of toe joint deformity is a procedure to fix misshapen toe joints. This can involve realigning the bones, removing bone or tissue, or implanting devices to improve joint function. It can help reduce pain and improve mobility.

This service was performed 89 times for 52 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 77 times for 39 patients

Fusion of big toe at joint with foot

Fusion of the big toe at the joint with the foot, also known as arthrodesis, is a surgical procedure aimed at relieving pain and improving stability. It involves permanently connecting the bones of the big toe and foot, which can limit movement but often enhances comfort and function.

This service was performed 34 times for 33 patients

Harvest of graft from large bone

Harvest of graft from large bone is a medical procedure where a small piece of bone is taken from a larger bone in your body. This bone graft is then used to help repair or rebuild another area where bone is damaged or missing, promoting healing and growth.

This service was performed 32 times for 32 patients

Incision of tendon covering of finger

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

This service was performed 13 times for 12 patients

Incision or partial removal of foot bone (other than big toe) to straighten toe

This procedure involves making a small incision to partially remove a bone in the foot, excluding the big toe. The aim is to straighten a misaligned toe. It helps in relieving pain, improving foot function, and enhancing shoe comfort.

This service was performed 43 times for 31 patients

Injection of anesthetic agent and/or steroid into other nerve or branch

This procedure involves injecting an anesthetic agent or steroid into a specific nerve or its branch. The goal is to relieve pain by reducing inflammation and numbing the area. It is commonly used for chronic pain management. The process is safe and usually quick.

This service was performed 29 times for 28 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 119 times for 74 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 174 times for 62 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 102 times for 69 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 33 times for 23 patients

Injection of upper or middle spine facet joint using imaging guidance, single level

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

This service was performed 31 times for 11 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.

This service was performed 69 times for 39 patients

Partial removal of foot or heel bone

This procedure involves the surgical removal of a portion of the foot or heel bone. It's typically done to treat conditions like arthritis, bone spurs, or injuries. The goal is to alleviate pain and improve mobility. After surgery, physical therapy may be necessary for full recovery.

This service was performed 13 times for 13 patients

Partial removal of toe bone

A partial removal of a toe bone, or partial toe amputation, is a surgical procedure where a portion of a toe bone is removed. This is often necessary to treat conditions like infection, injury, or bone disease. Recovery involves rest, medication, and potentially physical therapy.

This service was performed 13 times for 11 patients

Release of wrist ligament using an endoscope

This procedure involves using a small camera, called an endoscope, to view and treat a tight wrist ligament. The endoscope is inserted through a tiny incision, reducing recovery time and scarring. It helps to relieve pain and improve wrist function.

This service was performed 21 times for 20 patients

Removal of both knee cartilages using an endoscope

This procedure, also known as bilateral knee arthroscopy, involves using a small camera (endoscope) to view and remove damaged cartilage from both knees. It's a minimally invasive surgery aimed at relieving pain and improving mobility.

This service was performed 18 times for 18 patients

Removal of deep implant from bone

This procedure involves the careful extraction of an implant deeply embedded in a bone. A specialist makes a small incision, then utilizes precise instruments to reach and safely remove the implant. The area is then closed and monitored for healing.

This service was performed 45 times for 39 patients

Secondary repair of ruptured achilles tendon

Secondary repair of a ruptured Achilles tendon is a surgical procedure done after initial treatment has failed or wasn't possible. It involves rejoining the torn tendon ends and may require a graft (tissue from another part of your body or a donor) to strengthen the repair.

This service was performed 14 times for 14 patients

Transfer of deep tendon of foot with muscle rerouting

This procedure involves moving a deep tendon in your foot to a new location. It also includes rerouting a muscle to improve foot function. It's typically done to correct foot deformities or improve walking ability.

This service was performed 17 times for 17 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
36D1085878
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
June 30, 2024
Certificate Expiration Date
June 29, 2026
Laboratory Director
BABAK KHABIRI
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Polaris Surbery Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1649456021
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2689851204
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 8 + 9 + 8 + 5 + 1 + 2 + 0 + 4 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1649456021 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1144399890 THOMAS L HARMON M.D.
Individual
Obstetrics & Gynecology300 POLARIS PKWY SUITE 2600
WESTERVILLE, OH 43082
(614) 885-8167
1548339021 CARL A KRANTZ M.D.
Individual
Obstetrics & Gynecology300 POLARIS PKWY SUITE 2600
WESTERVILLE, OH 43082
(614) 885-8167
1437228087 STUART R JONES M.D.
Individual
Obstetrics & Gynecology300 POLARIS PKWY SUITE 2600
WESTERVILLE, OH 43082
(614) 885-8167
1457420911 TRACY COOK M.D.
Individual
Obstetrics & Gynecology300 POLARIS PKWY SUITE 2600
WESTERVILLE, OH 43082
(614) 885-8167
1386807543FOOTSOURCE MD, LLC
Organization
Durable Medical Equipment & Medical Supplies (Customized Equipment)300 POLARIS PKWY SUITE 2000
WESTERVILLE, OH 43082
(614) 895-8747
1477793107MR. JEFFERY A BRIGHT ATC
Individual
Specialist/Technologist (Athletic Trainer)300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3200
1538309448COLUMBUS ORTHOPAEDIC GROUP, INC.
Organization
Durable Medical Equipment & Medical Supplies300 POLARIS PKWY SUITE 2150
WESTERVILLE, OH 43082
(614) 759-1186
1770855488MOES - WESTERVILLE LLC
Organization
Emergency Medicine300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3000
1023302254DR. KATIE EILEEN STEELE M.D.
Individual
Obstetrics & Gynecology300 POLARIS PKWY SUITE 2600
WESTERVILLE, OH 43082
(614) 659-9519
1326565326MR. JEREMY SIMMONS
Individual
Specialist/Technologist (Athletic Trainer)300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3000
1649524224 NICOLE GALVIN PT, DPT, OCS
Individual
Physical Therapist300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3200
1053893966 MICHAEL GENCO PT, DPT
Individual
Physical Therapist300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3200
1134601040 EMILY REYNOLDS PTA
Individual
Physical Therapy Assistant300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3234
1477036333 CRAIG KIRST PT
Individual
Physical Therapist300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3200
1891278719DR. TIMOTHY RETHORN PT, DPT
Individual
Physical Therapist300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3200
1396228110 JOSEPH HAROLD DALY PHYSICAL THERAPIST
Individual
Physical Therapist (Orthopedic)300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3217
1568945236MRS. KEAVY EILEEN MCNAUGHTON-JAMES PT
Individual
Physical Therapist300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3022
1801379474 TARAH DAWN BRIGGS DPT
Individual
Physical Therapist300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3200
1134602709 NIA BERNER PTA
Individual
Physical Therapy Assistant300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3224
1538642061 ALLISON L CLINE PTA
Individual
Physical Medicine & Rehabilitation300 POLARIS PKWY
WESTERVILLE, OH 43082
(614) 533-3213

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649456021, enumerated in the NPI registry as an "organization" on January 15, 2008

The provider is located at 300 Polaris Pkwy Suite 110 Westerville, Oh 43082 and the phone number is (614) 566-0568

This medical organization specializes in Clinic/Center with taxonomy code 261QA1903X with a focus in Ambulatory Surgical

The provider might be accepting Accepts: Aetna CVS Health, Anthem Blue Cross and Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The most common procedures or services performed by this practitioner are: Aspiration and/or injection of fluid from large joint, Aspiration and/or injection of fluid from medium joint, Correction of toe joint deformity, Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint, Fusion of big toe at joint with foot, Harvest of graft from large bone, Incision of tendon covering of finger, Incision or partial removal of foot bone (other than big toe) to straighten toe, Injection of anesthetic agent and/or steroid into other nerve or branch, Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level, Injection of lower or sacral spine facet joint using imaging guidance, single level, Injection of substance into lower spine canal using imaging guidance, Injection of substance into middle or upper spine canal using imaging guidance, Injection of upper or middle spine facet joint using imaging guidance, single level, Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography, Partial removal of foot or heel bone, Partial removal of toe bone, Release of wrist ligament using an endoscope, Removal of both knee cartilages using an endoscope, Removal of deep implant from bone, Secondary repair of ruptured achilles tendon and Transfer of deep tendon of foot with muscle rerouting.

The provider's CLIA number is 36D1085878 for a "ambulatory surgery center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on January 15, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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