David Allen Polstra, ACNPC-AG is a medicare enrolled "General Acute Care Hospital" in Los Angeles, California. He graduated from nursing school in 2018 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice South Sound Inpatient Physicians Pllc and his current practice location is
1401 S Grand Ave, Los Angeles, California. You can reach out to his office (for appointments etc.) via phone at
(213) 748-2411.
David Allen Polstra is licensed to practice in California (license number 95009210) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1598251498.
Provider's Profile
| Full Name | David Allen Polstra |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 7 Years |
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| Location | 1401 S Grand Ave, Los Angeles, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- David Allen Polstra graduated from nursing school in 2018
NPI Data:
- NPI Number: 1598251498
- Provider Enumeration Date: 07/03/2018
- Last Update Date: 10/20/2023
Medicare PECOS Information:
- PECOS PAC ID: 8628425220
- Enrollment ID: I20231102003761
Medical Identifiers
Medical identifiers for David Allen Polstra such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1598251498 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | AP61493227 (Washington) | Secondary |
| 282N00000X | General Acute Care Hospital | 95009210 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| South Sound Inpatient Physicians Pllc | 5991618738 | 381 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. David Allen Polstra allows following entities to bill medicare on his behalf.
| Entity Name | South Sound Inpatient Physicians Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1023285756
PECOS PAC ID: 5991618738
Enrollment ID: O20031107000668 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. David Allen Polstra is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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David Allen Polstra, ACNPC-AG
2127 Camorilla Dr,
Los Angeles, CA 90065-3401
Ph: (323) 907-9895 | David Allen Polstra, ACNPC-AG
1401 S Grand Ave,
Los Angeles, CA 90015-3010
Ph: (213) 748-2411 |
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