Individual provider Active NPI

Stephanie Lynn Davidson, DO

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1134199409
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
T3455 Issued in TX
Practice address
9127 W Russell Rd Ste 110
Las Vegas, NV 89148-1253
Phone
(702) 878-0070
Fax
(702) 209-2064
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 982 NV
Anesthesiology Physician 207L00000X T3455 TX Primary

Addresses

Primary practice location

9127 W Russell Rd Ste 110
Las Vegas, NV 89148-1253

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (702) 878-0070

Other identifiers 1

IdentifierTypeStateIssuer
2018612MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040909000786 NV Practitioner - Anesthesiology 4486620580 Reassigns benefits to 1 organization
I20211220001132 TX Practitioner - Anesthesiology 4486620580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fielden,Hanson,Isaacs,Miyada,Robison,Yeh LTDGroup PAC ID 5799683462, 168 clinicians

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 961-8434

9127 W Russell Rd
Suite 110
Las Vegas, NV 89148-1253
Phone (702) 878-0700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.25 of 100Reported as group
Quality
74.41
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T3455TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Anesthesiology CurrentSince Nov 15, 2021 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Anesthesiology CurrentSince Nov 15, 2021 Accepting new patients
Fielden Hanson Isaacs Miyada Robison Yeh LTD Anesthesiology CurrentSince Sep 1, 2000 Accepting new patients
Arizona Anesthesia Consultants, Inc. Anesthesiology PastSince Feb 2, 2020 Accepting new patients

Locations

9127 W Russell Rd
Ste 110
Las Vegas, NV 89148
Phone (702) 209-2042

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

7220 S Cimarron Rd
Ste 230
Las Vegas, NV 89113
Phone (702) 209-2044

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

Organizations & group practices 4

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 1

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1134199409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "702-878-0070",
            "fax_number": "702-209-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9127 W RUSSELL RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481253",
            "telephone_number": "702-878-0070",
            "fax_number": "702-209-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "982",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "T3455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018612",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.