Individual provider Active NPI

Ryan Davidovich, M.D.

  • Anesthesiology Physician
  • Nashville, TN
National Provider Identifier
1033503412
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
63020 Issued in TN
Practice address
110 29TH Ave N Ste 201
Nashville, TN 37203-1458
Phone
(615) 327-4304
NPI assigned
Mar 24, 2015
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 66336 WI
Anesthesiology Physician 207L00000X 63020 TN Primary
General Practice Physician 208D00000X 66336-20 WI

Addresses

Primary practice location

110 29TH Ave N Ste 201
Nashville, TN 37203-1458

Mailing address

110 29TH Ave N Ste 201
Nashville, TN 37203-1458
Phone (615) 327-4304

Other identifiers 1

IdentifierTypeStateIssuer
1033503412MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190423000193 WI Practitioner - Anesthesiology 6406198480 Reassigns benefits to 1 organization
I20210928003113 TN Practitioner - Anesthesiology 6406198480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Mississippi School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Group, P.C.Group PAC ID 6901702307, 439 clinicians

Practice addresses (Care Compare)

2300 Patterson St
Nashville, TN 37203-1538
Phone (615) 342-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.57 of 100Reported as group
Quality
59.49
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
66336-20WIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Group, PC Anesthesiology CurrentSince Aug 16, 2021 Accepting new patients
Nashville Anesthesia PLLC Anesthesiology CurrentSince Jun 1, 2024 Accepting new patients
The Medical College of Wisconsin, Inc. Anesthesiology CurrentSince Apr 1, 2019 Accepting new patients
Aaa Anesthesia Associates LLC Anesthesiology PastSince Aug 15, 2021 Accepting new patients

Locations

110 29th Ave N
Ste 202
Nashville, TN 37203
Phone (615) 327-7870

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

391 Wallace Rd
Nashville, TN 37211
Phone (615) 332-6253

397 Wallace Rd
Ste 407
Nashville, TN 37211
Phone (615) 832-5530

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • Direct secure messaging: rdavidovichmd178232@direct.froedtert.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1033503412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N STE 201",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031458",
            "telephone_number": "615-327-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N STE 201",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031458",
            "telephone_number": "615-327-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOVICH",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "66336",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "63020",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "66336-20",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033503412",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.