Michael Kevin Davis, PA-C
Individual provider Active NPI Physician Assistant · Hockessin, DE
NPI 1003540410 · NPPES record last updated Nov 14, 2023
Key facts
- NPI
- 1003540410
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- C5-0011756 (DE)
- Practice address
- 316 Lantana Dr
Hockessin, DE 19707-8807 - Phone
- (302) 766-9700
- NPI assigned
- Jul 12, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Christiana Care Quality Partners
Practice addresses (Care Compare)
1 Chestnut Hill PLZ
Suite C
Newark, DE 19713-2761
Phone (302) 455-2730
1011 E Songsmith Dr
Christianacare Gohealth Urgent Care
Bear, DE 19701-1194
Phone (302) 918-7509
129 N Dupont Hwy
New Castle, DE 19720-3135
Phone (302) 501-6367
200 Hygeia Dr
Newark, DE 19713-2049
Phone (302) 273-1701
360 Buckley Mill Rd
Suite B
Greenville, DE 19807-3035
Phone (302) 299-1001
3926 Kirkwood Hwy
Wilmington, DE 19808-5110
Phone (302) 267-7534
4724 Limestone Rd
Wilmington, DE 19808-1928
Phone (302) 467-3595
550 S College Ave
115 Christianacare Gohealth Urgent Care
Newark, DE 19713-1324
Phone (302) 273-0727
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in PA, DE, MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220914000786 | PA | Practitioner - Physician Assistant | 7810372760 | Reassigns benefits to 1 organization |
| I20221006003288 | DE | Practitioner - Physician Assistant | 7810372760 | Reassigns benefits to 1 organization |
| I20231105000080 | MD | Practitioner - Physician Assistant | 7810372760 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C5-0011756 | DE | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christiana Care Quality Partners | Past |
Accepting new patients |
Interoperability endpoints
- michael.davis@ghuccc.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/HBCACD/Endpoint/HBCACD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C5-0011756 | DE | Yes |
Addresses
Primary practice location
316 Lantana Dr
Hockessin, DE 19707-8807
Mailing address
13 Laxford Dr
Newark, DE 19702-4265
Phone (302) 358-1053
Other practice location 1
200 Hygeia Dr
Newark, DE 19713-2049
Phone (302) 273-1701
Other practice location 2
310 E Pulaski Hwy
Elkton, MD 21921-6435
Phone (443) 485-6213
Other providers in Hockessin, DE
- Lisa E Crandell
- Fiona Eileen Cristinzio
- Denise Cybak
- Theresa B Dargis
- Corinne Daut
- Troy Anthony Day
- De Pacs 2 PA
- Dianna Declemente
- Madelyn Deford
- Delaware Home Care Specialists
All providers in Hockessin, DE · Physician Assistant in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.