Active NPI
David Pollak
- Psychiatry Physician
- Minneapolis, MN
National Provider Identifier
1629188453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 38296
- Practice address
- 825 Nicollet Mall
Minneapolis, MN 55402-2606 - Phone
- (612) 359-9464
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 38296 | MN | Primary |
Addresses
Primary practice location
825 Nicollet Mall
Minneapolis, MN 55402-2606
Mailing address
2012 Cedar Lake Pkwy
Minneapolis, MN 55416-3615
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38296 | MN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629188453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2012 CEDAR LAKE PKWY",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554163615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 NICOLLET MALL",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554022606",
"telephone_number": "612-359-9464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLAK",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "38296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.