NPIMap

Individual provider Active NPI

Justin Richard Davanzo, M.D.

  • Neurological Surgery Physician
  • Monroeville, PA
National Provider Identifier
1114269545
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD457862 Issued in PA
Practice address
2580 Haymaker Rd Ste 106
Monroeville, PA 15146-3500
Phone
(412) 858-7766
Fax
(412) 858-7769
NPI assigned
Mar 24, 2013
Last updated
Oct 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD457862 PA Primary

Addresses

Primary practice location

2580 Haymaker Rd Ste 106
Monroeville, PA 15146-3500

Mailing address

2580 Haymaker Rd Ste 106
Monroeville, PA 15146-3500
Phone (412) 858-7766

Other identifiers 1

IdentifierTypeStateIssuer
14653990OtherCAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdavanzo277039@direct.ahn.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200522000193 PA Practitioner - Neurosurgery 2567883895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Jefferson Medical College of Thomas Jefferson University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

2580 Haymaker Rd
Suite 106
Monroeville, PA 15146-3500
Phone (412) 858-7766

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion13
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD457862PAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic CurrentSince Jul 15, 2020 Accepting new patients
Allegheny Clinic Neurological Surgery CurrentSince Jul 15, 2020 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
West Penn Allegheny Health System Inc. Past Accepting new patients
Allegheny Clinic Past Accepting new patients
Allegheny Clinic Past Accepting new patients

Locations

1001 9th Ave
Brackenridge, PA 15014

6321 State Route 30
Greensburg, PA 15601
Phone (412) 858-7088

2580 Haymaker Rd
Ste 102
Monroeville, PA 15146
Phone (412) 856-9142

2580 Haymaker Rd
Ste 106
Monroeville, PA 15146
Phone (412) 374-1441

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

4815 Liberty Ave
Ste 439
Pittsburgh, PA 15224
Phone (412) 578-3925

701 Broad St
Ste 431
Sewickley, PA 15143
Phone (412) 741-0966

Interoperability endpoints

  • Direct secure messaging: jdavanzo277039@direct.ahn.org

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.

Hospital & facility affiliations 10

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": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1114269545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 106",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500",
            "telephone_number": "412-858-7766",
            "fax_number": "412-858-7769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 106",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500",
            "telephone_number": "412-858-7766",
            "fax_number": "412-858-7769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVANZO",
        "first_name": "JUSTIN",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-24",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD457862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14653990",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdavanzo277039@direct.ahn.org",
            "affiliation": "N",
            "address_1": "2580 Haymaker Rd Ste 106",
            "city": "Monroeville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "151463500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.