Dr. Robert Polak , MD
Surgery โข Miamisburg, OH
4000 Miamisburg Centerville Rd Ste 420
Miamisburg, OH 453427615
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on May 5, 2014; this date does not establish years in practice.
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Published CMS data list 54 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024. Published rows only; this is not a quality measure.
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Published Part B service records, 2024:
- 99214 โ Established patient outpatient office visit: 23 service units.
- 99213 โ Established patient outpatient office visit: 20 service units.
- 43239 โ Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope: 11 service units.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPTยฎ only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See the full table ยท Guide: How to read Medicare Part B data
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Published CMS data list 200 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Omeprazole โ 57 prescription fills, including refills.
- Ondansetron Odt (Ondansetron) โ 41 prescription fills, including refills.
- Oxycodone Hcl โ 28 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See all 8 records in the table ยท Guide: How to read Medicare Part D prescriber data
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Fewer Medicare Part B services than 85% of clinicians listed under Surgery in Ohio (2024, 638 clinicians with data). Median for this group: 187. Middle half: 93 to 324.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 64 in 2022 to 54 in 2024.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2022โ2024.
Practice Location & Contact Primary Location
4000 Miamisburg Centerville Rd Ste 420
Miamisburg, OH 453427615
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
NPPES lists 2 distinct additional practice-address records in Dayton, OH; Miamisburg, OH. See the list
Source: CMS NPPES NPI Registry, practice location records; release date unavailable.
CMS Doctors and Clinicians lists 1 group name: Kettering Independent Medical Group Inc. See the list
Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File
Texas Tech University Health Science Center School Of Medicine
2014
What Public CMS Data Show
Surgery: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
47 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider, 2024.
Medicare-allowed amount
About $5,505 in 2024
The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024.
Paid by Medicare
About $4,169 in 2024
The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024.
30-day fills
278 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$4,214 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024.
Open Payments general payments, program year 2025
All general payments: $425.16 across 2 records.
By nature of payment
- Education: $305.00 across 1 record.
- Food and Beverage: $120.16 across 1 record.
Reporting-company totals
- Medical Device Business Services, Inc.: $305.00 across 1 record.
- Eli Lilly and Company: $120.16 across 1 record.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).
Years since graduation
12 years (graduated 2014)
CMS Doctors and Clinicians data list 2014 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished school.
What this does not show: Years since graduation
It is not the number of years in practice, and more years does not mean better care.
Source: CMS Doctors and Clinicians National Downloadable File.
NPI first issued
2014
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Accepts Medicare assignment
CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, โDoes your provider accept Medicare as full payment?โ
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Dr. Polak has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Dr. Polak as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Miamisburg and Ohio
Billing and prescribing volume is not a quality rating.
Medicare Part B services
Fewer Medicare Part B services than 85% of clinicians listed under Surgery in Ohio (2024, 638 clinicians with data). Median for this group: 187. Middle half: 93 to 324.
Too few clinicians listed under Surgery in Miamisburg have Medicare Part B data for 2024 to compare.
Medicare-allowed amount
A lower Medicare-allowed amount than 80% of clinicians listed under Surgery in Ohio (2024, 638 clinicians with data). Median for this group: $22,357. Middle half: $10,121 to $39,971.
Too few clinicians listed under Surgery in Miamisburg have Medicare Part B data for 2024 to compare.
Paid by Medicare
A lower Medicare payment amount than 85% of clinicians listed under Surgery in Ohio (2024, 638 clinicians with data). Median for this group: $17,017. Middle half: $7,621 to $29,946.
Too few clinicians listed under Surgery in Miamisburg have Medicare Part B data for 2024 to compare.
Medicare Part D prescriptions
More Part D prescriptions than 80% of clinicians listed under Surgery in Ohio (2024, 620 clinicians with data). Median for this group: 64. Middle half: 28 to 134.
Too few clinicians listed under Surgery in Miamisburg have Medicare Part D data for 2024 to compare.
Part D drug cost
A higher Part D drug cost than 80% of clinicians listed under Surgery in Ohio (2024, 620 clinicians with data). Median for this group: $364. Middle half: $119 to $1,687.
Too few clinicians listed under Surgery in Miamisburg have Medicare Part D data for 2024 to compare.
3 active clinicians are listed under Surgery with a practice address in Miamisburg, OH (1,249 in Ohio).
Addresses are self-reported to NPPES and may be out of date.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services decreased 16% from 64 in 2022 to 54 in 2024.
- 2022: 64
- 2023: 30
- 2024: 54
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Medicare-allowed amount
Medicare-allowed amount decreased 16% from $6,523 in 2022 to $5,505 in 2024.
- 2022: $6,523
- 2023: $3,118
- 2024: $5,505
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Paid by Medicare
Paid by Medicare decreased 12% from $4,759 in 2022 to $4,169 in 2024.
- 2022: $4,759
- 2023: $2,139
- 2024: $4,169
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Medicare Part D prescriptions
Medicare Part D prescriptions went from 14 in 2020 to 200 in 2024.
- 2020: 14
- 2021: 67
- 2022: 205
- 2023: 139
- 2024: 200
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30-day fills
30-day fills went from 14 in 2020 to 278 in 2024.
- 2020: 14
- 2021: 73
- 2022: 233
- 2023: 171
- 2024: 278
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Part D drug cost
Part D drug cost went from $380 in 2020 to $4,214 in 2024.
- 2020: $380
- 2021: $1,743
- 2022: $27,059
- 2023: $1,452
- 2024: $4,214
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Industry payments (Open Payments)
Industry payments (Open Payments) went from $381.33 in 2021 to $425.16 in 2025.
- 2021: $381.33
- 2022: $1,768.61
- 2023: $121.17
- 2024: $494.51
- 2025: $425.16
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo ยท Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2025 (payments made January 1 โ December 31, 2025): fewer than 11 records totaling $425.16.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Medical Device Business Services, Inc. |
Education
In-kind items and services
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โ | General | $305.00 |
| Eli Lilly and Company |
Food and Beverage
Cash or cash equivalent
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ZEPBOUND | General | $120.16 |
Source: CMS Open Payments, program year 2025, released June 30, 2026.
Performed Procedures & Service Volume
CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2021โ2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ by Provider and Service data, 2022โ2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99214
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
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23 | 18 | $279.00 | $109.74 |
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99213
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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20 | 14 | $188.00 | $77.11 |
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43239
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope
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11 | 11 | $685.00 | $130.76 |
Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Omeprazole | Omeprazole | 57 | 3,808 | $600.20 | 29 |
| Ondansetron Odt | Ondansetron | 41 | 270 | $526.43 | 23 |
| Oxycodone Hcl | Oxycodone Hcl | 28 | 203 | $173.59 | 19 |
| Methocarbamol | Methocarbamol | 25 | 523 | $68.39 | โ |
| Promethazine Hcl | Promethazine Hcl | 14 | 93 | $66.33 | 12 |
| Hydrocodone-Acetaminophen | Hydrocodone/Acetaminophen | 13 | 131 | $128.88 | โ |
| Dicyclomine Hcl | Dicyclomine Hcl | 11 | 330 | $330.03 | โ |
| Sucralfate | Sucralfate | 11 | 480 | $2,320.27 | โ |
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2025-08-18NUCC Taxonomy Code: 208600000X
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
NUCC Taxonomy Code: 208600000X
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - GENERAL SURGERY
I20210831002334
OH
2567760796
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Medicare Group Practice Enrollments
Source: CMS Doctors and Clinicians National Downloadable File
Kettering Independent Medical Group Inc
7740 Washngton Vlg Dr, Dayton, OH 454593994
Phone: 9374394145
Kettering Independent Medical Group Inc
4441 Far Hills Ave, Kettering, OH 454292405
Phone: 9372987751
Kettering Independent Medical Group Inc
7740 Washington Village Dr, Centerville, OH 454593994
Phone: 9374334325
Kettering Independent Medical Group Inc
4000 Miamisburg Centerville Rd, Miamisburg, OH 453427615
Kettering Independent Medical Group Inc
4403 Far Hills Ave, Kettering, OH 454292405
Phone: 9374335309
Secondary Practice Locations
4000 Miamisburg Centerville Rd Ste 435
Miamisburg, OH 453427615
Phone: 9374335957
7740 Washington Village Dr Ste 110
Dayton, OH 454593994
Phone: 9374394145
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Surgery
Doctor of Osteopathic Medicine (D.O.)
Surgery
Doctor of Medicine (M.D.)
Surgery
Doctor of Osteopathic Medicine (D.O.)
Physician Assistant
Physician Assistant (Certified)
Physician Assistant
Physician Assistant
Physician Assistant
Physician Assistant (Certified)
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 4000 MIAMISBURG CENTERVILLE RD STE 420, MIAMISBURG, OH 453427615 (Tel: 9374394145)
Registered at 1 PRESTIGE PL STE 550, MIAMISBURG, OH 453426115 (Tel: 9377621310)
Surgery (license number reported to NPPES: TX BP10049567)
Registered at 7740 WASHINGTON VILLAGE DR STE 110, DAYTON, OH 454593994 (Tel: 9374394145)
Registered at 7740 WASHINGTON VILLAGE DR STE 110, DAYTON, OH 454593994 (Tel: 9374394145)
Surgery (license number reported to NPPES: OH 35.143165)
NPI status registered as active in NPPES database
Registered at 3601 4TH ST, STOP 8312, LUBBOCK, TX 794300002 (Tel: 8067432373)
Registered at 3601 4TH ST, STOP 8312, LUBBOCK, TX 794300002 (Tel: 8067432373)
Recorded as ROBERT POLAK, M.D.
Surgery (license number reported to NPPES: TX BP10049567)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Mailing Address
1 Prestige Pl Ste 550
Miamisburg, OH 453426115
Phone: 9377621310