DAVID WILLIAM BERREYESA POLOWAY (DO) – Emergency Medicine Physician, NPI 1316680911

DAVID WILLIAM BERREYESA POLOWAY (DO) is a healthcare provider. based in Flushing, New York. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. 334696 (NY). The NPI Number for DAVID WILLIAM BERREYESA POLOWAY (DO) is 1316680911

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
DAVID WILLIAM BERREYESA POLOWAY (DO)
NPI
1316680911
Phone
Not provided
Address
5645 MAIN ST
Enumeration Date
20 April 2022
Last Update Date
3 December 2025

Doctor Profile

Medical School Name
ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Secondary Phone
9549395000
Graduation Year
2022 (4 years ago)
PAC ID
0547771214
Group Practice PAC ID
8325263171
Professional Enrollment ID
I20250618003562
Address ID
NY113555045FL5645XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

4,917 EMERGENCY MEDICINE in NY

Provider Addresses for DAVID WILLIAM BERREYESA POLOWAY (DO)

  • 5645 MAIN ST

    FLUSHING, NY 113555045

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250618003562IEmergency MedicineNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 11355)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325263171View full group profile
NameSpecialtyState
Nurse PractitionerNY
Emergency MedicineNY
Emergency MedicineNJ
Emergency MedicineNY
Emergency MedicineNJ
Emergency MedicineNY
Emergency MedicineNY
Emergency MedicineNY
Emergency MedicineWV
Emergency MedicineNY

Reviews

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Frequently asked questions

Can I cross-check DAVID WILLIAM BERREYESA POLOWAY (DO) using NPI 1316680911?
NPI 1316680911 belongs to DAVID WILLIAM BERREYESA POLOWAY (DO); compare other details if you need extra assurance.
Active or inactive — what applies to DAVID WILLIAM BERREYESA POLOWAY (DO)?
You should see DAVID WILLIAM BERREYESA POLOWAY (DO) as active in CMS-hosted NPPES data.
What expertise is attributed to DAVID WILLIAM BERREYESA POLOWAY (DO)?
DAVID WILLIAM BERREYESA POLOWAY (DO)'s specialty line reads Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DAVID WILLIAM BERREYESA POLOWAY (DO) located near Flushing?
DAVID WILLIAM BERREYESA POLOWAY (DO) currently maps to Flushing, New York in this extract.
Can I trust this NPI listing for DAVID WILLIAM BERREYESA POLOWAY (DO)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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