Individual provider Active NPI

Courtney Davila, NP

  • Family Nurse Practitioner
  • Riverhead, NY
National Provider Identifier
1083116040
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
342365 Issued in NY
Practice address
951 Roanoke Ave
Riverhead, NY 11901-2724
Phone
(631) 727-7773
Fax
(631) 727-7832
NPI assigned
Mar 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 342365 NY Primary

Addresses

Primary practice location

951 Roanoke Ave
Riverhead, NY 11901-2724

Mailing address

951 Roanoke Ave
Riverhead, NY 11901-2724
Phone (631) 727-7773

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180828002935 NY Practitioner - Nurse Practitioner 1557610342 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York Downstate Medical Center, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1601 County Rd
Suite 39
Southampton, NY 11968-5295
Phone (631) 283-2070

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

80 E Montauk Hwy
Hampton Bays, NY 11946-1878
Phone (631) 728-0966

889 Harrison Ave
FL 3B
Riverhead, NY 11901-2090
Phone (631) 824-1360

951 Roanoke Ave
Riverhead, NY 11901-2724
Phone (631) 727-7832

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Jun 6, 2018 Accepting new patients
Peconic Cardiology, PC Single Specialty CurrentSince Dec 28, 2022 Accepting new patients
North Shore-Lij Medical PC Single Specialty CurrentSince Jun 6, 2018 Accepting new patients

Locations

1001 Franklin Ave
Garden City, NY 11530
Phone (516) 240-8700

80 E Montauk Hwy
Hampton Bays, NY 11946
Phone (631) 604-4022

300 Community Dr
Plandome, NY 11030

1272 E Main St
Riverhead, NY 11901
Phone (631) 284-3793

1333 Heroes Way
Riverhead, NY 11901
Phone (631) 727-2755

951 Roanoke Ave
Riverhead, NY 11901
Phone (631) 369-5005

889 Harrison Ave
Fl 3A
Riverhead, NY 11901
Phone (631) 390-7128

1601 County Road 39
Southampton, NY 11968
Phone (631) 283-2070

6144 Route 25A
Ste 14
Wading River, NY 11792
Phone (631) 707-8771

271 Route 25A
Wading River, NY 11792
Phone (631) 929-4100

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: cdavila60777@northwell.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1083116040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012724",
            "telephone_number": "631-727-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012724",
            "telephone_number": "631-727-7773",
            "fax_number": "631-727-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.