Individual provider Active NPI

Aida R Polson, MD

  • Internal Medicine Physician
  • Powell, WY
National Provider Identifier
1881649655
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7734A Issued in WY
Practice address
777 Avenue H
Powell, WY 82435-2260
Phone
(307) 754-7257
Fax
(307) 754-7730
NPI assigned
May 23, 2006
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M-9474 ID
Internal Medicine Physician 207R00000X 7734A WY Primary

Addresses

Primary practice location

777 Avenue H
Powell, WY 82435-2260

Mailing address

777 Avenue H
Powell, WY 82435
Phone (307) 754-7257

Other identifiers 1

IdentifierTypeStateIssuer
1881649655MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071004000036 WY Practitioner - Internal Medicine 3870517402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powell Valley Healthcare IncGroup PAC ID 5092798561, shared by 5 NPIs, 31 clinicians

Practice addresses (Care Compare)

450 Mountain View
Powell, WY 82435-2212
Phone (307) 754-7257

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.54 of 100Reported as group
Quality
71.68
Promoting interoperability
100
Improvement activities
40
Cost
70.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-9474IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Powell Valley Health Care Inc CurrentSince Feb 1, 2016 Accepting new patients
Powell Valley Healthcare Inc Internal Medicine CurrentSince Feb 1, 2016 Accepting new patients
Riverton Physician Practices, LLC Past Accepting new patients

Locations

450 Mountain View St
Powell, WY 82435
Phone (307) 754-2267

777 Avenue H
Powell, WY 82435
Phone (307) 754-1175

Interoperability endpoints

  • Direct secure messaging: apolson@powellvalleyhealthcare.cernerdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1881649655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "82435",
            "telephone_number": "307-754-7257",
            "fax_number": "307-857-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352260",
            "telephone_number": "307-754-7257",
            "fax_number": "307-754-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSON",
        "first_name": "AIDA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-9474",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "7734A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881649655",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

Sources for this page

Verify at the official NPI Registry.