NPIMap

Individual provider Active NPI

David Vattathara Polson, MD

  • Family Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1417539248
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD486230 Issued in PA
Practice address
111 Sheridan St
Pittsburgh, PA 15209-2638
Phone
(412) 821-2277
NPI assigned
Apr 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD486230 PA Primary

Addresses

Primary practice location

111 Sheridan St
Pittsburgh, PA 15209-2638

Mailing address

111 Sheridan St
Pittsburgh, PA 15209-2638
Phone (412) 821-2277

Other practice location 1

111 Sheridan St
Pittsburgh, PA 15209-2638
Phone (412) 821-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250812000281 PA Practitioner - Family Practice 5698273423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renaissance Family Practice-Upmc, IncGroup PAC ID 7012085558, 44 clinicians

Practice addresses (Care Compare)

111 Sheridan St
Pittsburgh, PA 15209-2639
Phone (412) 821-2277

200 Delafield Rd
Pittsburgh, PA 15215-3214

Hospital & facility affiliations

  • Upmc St Margaret Hospital, Pittsburgh, PA, CCN 390102
  • Upmc Passavant Hospital, Pittsburgh, PA, CCN 390107

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD486230PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Family Practice-Upmc, Inc Family Medicine Current Accepting new patients
Renaissance Family Practice-Upmc,Inc CurrentSince Aug 1, 2025 Accepting new patients
Renaissance Family Practice, Inc Family Medicine Past Accepting new patients

Locations

200 Delafield Rd
Ste 3010
Pittsburgh, PA 15215
Phone (412) 781-1832

111 Sheridan St
Pittsburgh, PA 15209
Phone (412) 821-2277

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

Interoperability endpoints

  • Direct secure messaging: david.polson@upmcdirect.com

Organizations & group practices 3

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1417539248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SHERIDAN ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152092638",
            "telephone_number": "412-821-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SHERIDAN ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152092638",
            "telephone_number": "412-821-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152092638",
            "country_code": "US",
            "telephone_number": "412-821-2277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLSON",
        "first_name": "DAVID",
        "middle_name": "VATTATHARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD486230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.