Individual provider Active NPI

Steven Earl Davis, D.O.

  • Family Medicine Physician
  • San Dimas, CA
National Provider Identifier
1154300978
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A5217 Issued in CA
Practice address
1125 Via Verde
San Dimas, CA 91773-4400
Phone
(909) 592-9778
Fax
(909) 599-6126
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A5217 CA Primary

Addresses

Primary practice location

1125 Via Verde
San Dimas, CA 91773-4400

Mailing address

1125 Via Verde
San Dimas, CA 91773-4400
Phone (909) 592-9778

Other identifiers 1

IdentifierTypeStateIssuer
00AX52170MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050728000725 CA Practitioner - Family PracticePractitioner - General Practice 4082642301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
College of Osteo Med of the Pacific at Pomona, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emanate Health Medical Care FoundationGroup PAC ID 9830544980, 85 clinicians

Practice addresses (Care Compare)

1115 S Sunset Ave
West Covina, CA 91790-3940

1305 W Arrow Hwy
Suite 104
San Dimas, CA 91773-2337
Phone (909) 394-9004

Merit-based Incentive Payment System (MIPS)

Final score
84.36 of 100Reported as group
Quality
60.04
Promoting interoperability
87
Improvement activities
40
Cost
69.31

Merit-based Incentive Payment System (MIPS)

Final score
82.35 of 100Reported as group
Quality
52.92
Promoting interoperability
93
Improvement activities
40
Cost
70.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A5217CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Care Foundation CurrentSince Jan 1, 2024 Accepting new patients
Emanate Health Medical Group Family Medicine CurrentSince Oct 1, 2020 Accepting new patients
Citrus Valley Physician Partners CurrentSince Oct 1, 2020 Accepting new patients
Emanate Health Medical Group Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients

Locations

14375 Pipeline Ave
Chino, CA 91710
Phone (626) 918-6544

147 W College St
Covina, CA 91723
Phone (626) 332-2860

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

1125 Via Verde
San Dimas, CA 91773
Phone (909) 592-8170

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1154300978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 VIA VERDE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917734400",
            "telephone_number": "909-592-9778",
            "fax_number": "909-599-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 VIA VERDE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917734400",
            "telephone_number": "909-592-9778",
            "fax_number": "909-599-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "STEVEN",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX52170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.