DR. DAVID W POLLY JR. MD
NPI 1669483046
Orthopaedic Surgery in Minneapolis, MN
About Dr. David W Polly Jr. Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DAVID W POLLY JR. MD (NPI 1669483046) is an individual orthopaedic surgery provider in Minneapolis, Minnesota, licensed in Minnesota (34661) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 15
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. David W Polly Jr. Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show David Polly reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Minneapolis, MN 55455
- Reassigned Medicare billing, Minnesota enrollment
- 3,633 clinicians in this Medicare group
Woodbury, MN 55125
- Reassigned Medicare billing, Minnesota enrollment
- 35 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55454 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is David Polly's NPI number?
The NPI number for David Polly is 1669483046. It was assigned to this individual provider in the NPPES registry on August 10, 2006.
Where is David Polly located?
David Polly practices at University Of Minnesota Physicians 2512 South 7th Street, Suite R102, Minneapolis, MN 55454. The listed phone number is (612) 273-9400.
What is David Polly's specialty?
The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.
Is David Polly enrolled in Medicare?
Yes. David Polly is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for David Polly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Polly reassigns Medicare benefits to 2 organizations: Fairview Express Care (Minneapolis, MN) and Shriners Hospitals For Children (Woodbury, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for David Polly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for David Polly was last updated on October 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. David W Polly Jr., MD · NPI 1669483046
Orthopaedic Surgery physician in Minneapolis, Minnesota. Individual provider, active in the CMS NPPES registry since August 10, 2006.
## Identity
- **NPI:** 1669483046 (Entity type: Individual)
- **Enumerated:** August 10, 2006
- **Primary specialty:** Orthopaedic Surgery · taxonomy 207X00000X
- **State license:** 34661 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** UNIVERSITY OF MINNESOTA PHYSICIANS, 2512 SOUTH 7TH STREET, SUITE R102, Minneapolis, MN 55454
- **Phone:** (612) 273-9400
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Fairview Express Care (NPI 1629224258, Minneapolis, MN); Shriners Hospitals For Children (NPI 1285250977, Woodbury, MN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 26, 2012
- **Other identifiers:** Other 131005; Medicaid 10387 (ND); Medicaid 7777470 (SD); and 12 more
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Source: [NPI Profile](https://npiprofile.com/npi/1669483046) · Data from the CMS NPPES public registry.