Individual provider Active NPI

Richard S Davidson, M.D.

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1104847789
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD026953E Issued in PA
Practice address
34TH & Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104-4306
Phone
(215) 590-1527
Fax
(215) 590-1501
NPI assigned
Jul 21, 2006
Last updated
Mar 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD026953E PA Primary
Pediatrics Physician 208000000X MD026953E PA

Addresses

Primary practice location

34TH & Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104-4306

Mailing address

100 E Penn SQ
The Wanamaker Building 9TH FL
Philadelphia, PA 19107-3323
Phone (267) 425-9538

Other identifiers 2

IdentifierTypeStateIssuer
000860890MedicaidPA
556301MedicaidNJ

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
I20080514000755 PA Practitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 3274602438 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (267) 425-9505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD026953EPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Surgical Associates LTD Current Accepting new patients
Shriners Hospitals for Children CurrentSince Apr 17, 2015 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Jan 14, 2009 Accepting new patients
Shriners Hospitals for Children CurrentSince Apr 17, 2015 Accepting new patients
Childen's Health Care Associates Inc. CurrentSince Jan 14, 2009 Accepting new patients
Children's Surgical Associates LTD CurrentSince Oct 3, 2022 Accepting new patients
Children's Surgical Associates LTD Past Accepting new patients
Children's Surgical Associates LTD Orthopaedic Surgery Past Accepting new patients
Children's Surgical Associates LTD Past Accepting new patients

Locations

1 Childrens Ctr
Philadelphia, PA 19104
Phone (215) 590-3450

100 E Penn Sq
Bldg 9TH
Philadelphia, PA 19107
Phone (267) 425-9538

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3401 Civic Center Blvd
Ste 34
Philadelphia, PA 19104

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

3551 N Broad St
Philadelphia, PA 19140
Phone (215) 430-4000

Organizations & group practices 10

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1104847789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "THE WANAMAKER BUILDING 9TH FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9538",
            "fax_number": "267-425-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34TH & CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044306",
            "telephone_number": "215-590-1527",
            "fax_number": "215-590-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "RICHARD",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD026953E",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD026953E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000860890",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "556301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.