Monica Agnes Davis, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

003351 Issued in NY

Practice address

5547 W Main St
Verona, NY 13478-3426

Phone

(315) 363-3482

Fax

(315) 363-1957

NPI assigned

Jul 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Oneida Health Systems, Inc

  • General Acute Care Hospital
  • Oneida, NY
  • NPI 1962408203
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1013948637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5547 W MAIN ST",
            "city": "VERONA",
            "state": "NY",
            "postal_code": "134783426",
            "telephone_number": "315-363-3482",
            "fax_number": "315-363-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5547 W MAIN ST",
            "city": "VERONA",
            "state": "NY",
            "postal_code": "134783426",
            "telephone_number": "315-363-3482",
            "fax_number": "315-363-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MONICA",
        "middle_name": "AGNES",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "003351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P.A. LICENSE",
            "identifier": "003351",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01622444",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Carney, LPN
• Diane P Clute, NP
• Andrea Mary Connery, MS CCC SLP
• Megan Cycon
• Caroline Louise Dart, OTR/L
• Kelsey Froass
• Meghan Furner
• Samantha Gwyther
• Azerina Habib, FNP
• Paula Haley

• All providers in Verona, NY
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.