Individual provider Active NPI

Nicole Marissa Davidson, MD

  • Pediatrics Physician
  • Pittsburgh, PA
National Provider Identifier
1093278475
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD489738 Issued in PA
Practice address
4401 Penn Ave
Pittsburgh, PA 15224-1334
Phone
(412) 692-5180
NPI assigned
Apr 11, 2019
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD489738 PA Primary

Addresses

Primary practice location

4401 Penn Ave
Pittsburgh, PA 15224-1334

Mailing address

4401 Penn Ave
Pittsburgh, PA 15224-1334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251017000777 PA Practitioner - Pediatric Medicine 3274869938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Ohio State University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Hot Meal St
Pittsburgh, PA 15203-2348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD489738PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Pediatrics CurrentSince Sep 1, 2025 Accepting new patients
University of Pittsburgh Physicians CurrentSince Sep 1, 2025 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Upmc Children's Hospital of Pittsburgh Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Upmc Emergency Medicine Inc Past Accepting new patients

Locations

865 Eisenhower Blvd
Johnstown, PA 15904
Phone (814) 266-8840

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

519 Penn Ave
Ste 206
Turtle Creek, PA 15145
Phone (412) 823-3121

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1093278475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241334",
            "telephone_number": "412-692-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "NICOLE",
        "middle_name": "MARISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD489738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.