NPIMap

Individual provider Active NPI

William W Davito, D.O.

  • Family Medicine Physician
  • Bartlesville, OK
National Provider Identifier
1164417515
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3185 Issued in OK
Practice address
4150 SE Adams Rd
Bartlesville, OK 74104-8410
Phone
(918) 331-9979
Fax
(918) 331-2346
NPI assigned
Sep 13, 2005
Last updated
Jan 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3185 OK Primary
Adolescent Medicine (Family Medicine) Physician 207QA0000X 27912 KS

Addresses

Primary practice location

4150 SE Adams Rd
Bartlesville, OK 74104-8410

Mailing address

4150 SE Adams Rd
Bartlesville, OK 74006
Phone (918) 331-9979

Other identifiers 2

IdentifierTypeStateIssuer
100112210DMedicaidOK
100112210CMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20100717000208 OK Practitioner - Family Practice 1850482266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Associates PCGroup PAC ID 9335486174, 5 clinicians

Practice addresses (Care Compare)

510 SE Delaware Ave
Bartlesville, OK 74003-3635
Phone (918) 331-2330

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3185OKMDProfessional Counselor
27912KSMDAdolescent Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bartlesville Care Center Inc. Past Accepting new patients
Gemini Medical Group Inc Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: william.davito.2@21171.direct.athenahealth.com
  • Direct secure messaging: william.davito@direct.stjohnhealthsystem.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bartlesville Health & Rehabilitation CommunityBartlesville, OK, CCN 375110 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2004
May 1, 2004
Comforting Hands Hospice LLCBartlesville, OK, CCN 371682 Hospice Contracted Managing Employee Apr 13, 2007

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 6

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1164417515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 SE ADAMS RD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74006",
            "telephone_number": "918-331-9979",
            "fax_number": "918-331-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 SE ADAMS RD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "741048410",
            "telephone_number": "918-331-9979",
            "fax_number": "918-331-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVITO",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3185",
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "KS",
            "license": "27912",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112210D",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112210C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.