Mark Davidov, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

25MA09263200 Issued in NJ

Practice address

65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102

Phone

(609) 748-7597

NPI assigned

Sep 25, 2008

Last updated

Aug 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 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

Specialty

Anesthesiology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Atlanticare Regional Medical CenterGroup PAC ID 0648181578, 86 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064
• Robert Packer Hospital Hospital, Sayre, PA, CCN 390079

Merit-based Incentive Payment System (MIPS)

Final score

79.93 of 100Reported as group

Quality

75.13

Promoting interoperability

100

Improvement activities

40

Cost

57.97

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Atlanticare Regional Medical Center

  dba ARMC Anesthesiologists

  • Anesthesiology Physician
  • Pomona, NJ
  • NPI 1710930102
  Medicare reassignment Care Compare group NPD
• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Athens, PA
  • NPI 1962451153
  Medicare reassignment Care Compare group
• Atlanticare Regional Medical Center

  dba Atlanticare Commuity Pharmacy - Atlantic City

  • Community/Retail Pharmacy
  • Atlantic City, NJ
  • NPI 1235677378
  NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644

  Anesthesiology

  NPD
• Guthrie Medical Group, P.C.

  • Anesthesiology Physician
  • Sayre, PA
  • NPI 1376594176
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  Care Compare affiliation
• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Care Compare affiliation
• Robert Packer Hospital

  dba Robert Packer Hospital, Towanda Campus

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  Care Compare affiliation

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377388800000",
    "number": "1154571164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 W JIMMIE LEEDS RD",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W JIMMIE LEEDS RD",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409102",
            "telephone_number": "609-748-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOV",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2013-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301097628",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA09263200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shady Daniel, RPH
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• Zoe Marie Deakyne
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• Jessica Deiter, CRNA
• Shela Delos Reyes, PHARMD
• Magdaline Delvalle, CRNA

• Anesthesiology Physician in Pomona, NJ
• Providers in Pomona, NJ by specialty
• Anesthesiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.