David Allen Polstra, ACNPC-AG

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

95009210 Issued in CA

Practice address

1401 S Grand Ave
Los Angeles, CA 90015-3010

Phone

(213) 748-2411

NPI assigned

Jul 3, 2018

Last updated

Oct 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Sound Inpatient Physicians PLLCGroup PAC ID 5991618738, 424 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Multicare Auburn Medical Center Hospital, Auburn, WA, CCN 500015
• Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154
• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
• Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• South Sound Inpatient Physicians PLLC

  dba Sound Inpatient Physicians

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1023285756

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• South Sound Inpatient Physicians PLLC

  dba Sound Inpatient Physicians

  • Internal Medicine Physician
  • Burien, WA
  • NPI 1467629196
  NPD
• South Sound Inpatient Physicians PLLC

  dba Sound Inpatient Physicians

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1508023789
  NPD
• Multicare Health System

  dba MultiCare Auburn Medical Center

  • General Acute Care Hospital
  • Auburn, WA
  • NPI 1255327201
  NPD (past)

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

• Multicare Health System

  dba MultiCare Auburn Medical Center

  • General Acute Care Hospital
  • Auburn, WA
  • NPI 1255327201
  Care Compare affiliation
• Multicare Health System

  dba MultiCare Covington Medical Center

  • General Acute Care Hospital
  • Covington, WA
  • NPI 1326564071
  Care Compare affiliation
• Multicare Health System

  dba Tacoma General Allenmore

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation
• Multicare Health System

  dba MultiCare Good Samaritan Hospital

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  Care Compare affiliation

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1598251498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 CAMORILLA DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900653401",
            "telephone_number": "323-907-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153010",
            "telephone_number": "213-748-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSTRA",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "95009210",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61493227",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shellee Pollard, L.C.S.W.
• Charles Pollick, M.D.
• Doris Pollock, MD
• Jillian A. Polonchak, AGACNP-BC
• Douglas Polster, PHD
• Daniel Lawrence Polyakov
• Gabrielle Erica Polyakov, DDS
• John Polykandriotis, MS, CGC
• Jennifer Kay Polzin, PHARM.D
• Pom Pom's Castle (Clean and Free)

• General Acute Care Hospital in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Acute Care Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.