Active NPI
Jonathan Davila, M.D.
- Urology Physician
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 309180-01
- Practice address
- 1400 Pelham Pkwy S
Bronx, NY 10461-1138 - Phone
- (718) 696-2583
- Fax
- (718) 881-5074
- NPI assigned
- Mar 24, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Urology Physician | 208800000X | 309180-01 | NY | Primary |
Addresses
Primary practice location
1400 Pelham Pkwy S
Bronx, NY 10461-1138
Mailing address
1400 Pelham Pkwy S
Bronx, NY 10461-1138
Phone (718) 696-2583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1441 S Ave
Staten Island, NY 10314-3779
Phone (718) 226-6461
300 Community Dr
Manhasset, NY 11030-3816
300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229
330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550
350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845
375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-6902
475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980
Hospital & facility affiliations
- Staten Island University Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309180-01 | NY | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Urology | Current | Accepting new patients |
| Staten Island University Hospital | Past | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
300 Community Dr
Plandome, NY 11030
1441 South Ave
Ste 205
Staten Island, NY 10314
972 Brush Hollow Rd
Westbury, NY 11590
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
Interoperability endpoints
- jdavila25660@northwell.direct-ci.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- General Acute Care Hospital
- Staten Island, NY
- NPI 1407877137
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Staten Island, NY
- NPI 1407877137
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656028800000",
"number": "1013448612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S",
"city": "BRONX",
"state": "NY",
"postal_code": "104611138",
"telephone_number": "718-696-2583",
"fax_number": "718-881-5074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S",
"city": "BRONX",
"state": "NY",
"postal_code": "104611138",
"telephone_number": "718-696-2583",
"fax_number": "718-881-5074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVILA",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-24",
"last_updated": "2022-06-24",
"certification_date": "2022-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "309180-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.