Individual provider Active NPI

Davoren Ann Chick, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1124056411
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD463225 Issued in PA
Practice address
3701 Market St
Ste 640
Philadelphia, PA 19104-5545
Phone
(215) 662-2250
Fax
(215) 615-3995
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD463225 PA Primary

Addresses

Primary practice location

3701 Market St
Ste 640
Philadelphia, PA 19104-5545

Mailing address

3701 Market St
Ste 640
Philadelphia, PA 19104-5545
Phone (215) 662-2250

Other identifiers 1

IdentifierTypeStateIssuer
4339117MedicaidMI

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
I20181206000252 PA Practitioner - HospitalistPractitioner - Internal Medicine 4486662731 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Columbia University College of Physicians and Surgeons, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of the University of PennsylvaniaGroup PAC ID 2062326507, 150 clinicians

Practice addresses (Care Compare)

700 Spruce St
Philadelphia, PA 19106-4022
Phone (215) 829-3521

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine Current Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 2019 Accepting new patients
University of Penn - Medical Group Internal Medicine Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jan 12, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Jan 12, 2020 Accepting new patients
Trustees of the University of Pennsylvania Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
University of Penn-Medical Group Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

700 Spruce St
Ste 304
Philadelphia, PA 19106
Phone (215) 829-3521

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

3701 Market St
Fl 6
Philadelphia, PA 19104
Phone (215) 662-2250

3701 Market St
Ste 640
Philadelphia, PA 19104
Phone (215) 662-2250

3701 Market St
Fl 7
Philadelphia, PA 19104
Phone (215) 349-5200

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1124056411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 MARKET ST",
            "address_2": "STE 640",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045545",
            "telephone_number": "215-662-2250",
            "fax_number": "215-615-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 MARKET ST",
            "address_2": "STE 640",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045545",
            "telephone_number": "215-662-2250",
            "fax_number": "215-615-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICK",
        "first_name": "DAVOREN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD463225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4339117",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.