NPIMap

Individual provider Active NPI

David A Polisner, MD

  • Internal Medicine Physician
  • Portland, ME
National Provider Identifier
1013080852
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20060891 Issued in NC
Practice address
144 State St
Portland, ME 04101-3776
Phone
(207) 879-3000
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20060891 NC Primary

Addresses

Primary practice location

144 State St
Portland, ME 04101-3776

Mailing address

144 State St
Portland, ME 04101-3776
Phone (207) 879-3000

Other identifiers 1

IdentifierTypeStateIssuer
5904498MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071003000035 ME Practitioner - Internal MedicinePractitioner - Geriatric Medicine 1557362191 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Geisel School of Medicine at Dartmouth, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134

Hospital & facility affiliations

  • Andwell Health Partners Hospice, Scarborough, ME, CCN 201511
  • Northern Light Home Care & Hospice Hospice, South Portland, ME, CCN 201502
  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Cedars Nursing Care Center Nursing home, Portland, ME, CCN 205003
  • Springbrook Center Nursing home, Westbrook, ME, CCN 205068

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20060891NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 27, 2018 Accepting new patients
Maine Medical Partners Internal Medicine Current Accepting new patients
Mainehealth Internal Medicine Current Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Aug 27, 2018 Accepting new patients
Maine Medical Partners CurrentSince Aug 27, 2018 Accepting new patients
Maine Medical Partners CurrentSince Aug 27, 2018 Accepting new patients
Mainehealth CurrentSince Aug 27, 2018 Accepting new patients
Cedars Nursing Care Center Inc Past Accepting new patients
Westbrook Operations, LLC Past Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

66 Bramhall St
Ste G1
Portland, ME 04102
Phone (207) 662-2847

630 Ocean Ave
Portland, ME 04103
Phone (207) 221-7000

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: dpolisner178685@direct.mmc.mainehealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Springbrook CenterWestbrook, ME, CCN 205068 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 9, 2022
Mar 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 40

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 40

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1013080852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-879-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-879-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISNER",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "20060891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904498",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.