Tristan L Davis, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101025356 Issued in MI

Practice address

1700 Clinton St
Muskegon, MI 49442-5502

Phone

(231) 728-4936

NPI assigned

Jun 29, 2017

Sex

Female

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 MI

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

Specialty

Emergency Medicine

Education

Michigan State University College of Osteopathic Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Michigan Observation Services PLLCGroup PAC ID 3375938889, 30 clinicians

Lake Michigan Emergency Specialists, PLLCGroup PAC ID 0749569242, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
• Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174
• Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tdavis42791@direct.trinity-health.org

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.

• Lake Michigan Emergency Specialists, PLLC

  • Emergency Medicine Physician
  • Muskegon, MI
  • NPI 1124574520
  Medicare reassignment Care Compare group NPD
• Lake Michigan Observation Services PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Muskegon, MI
  • NPI 1518626043
  Medicare reassignment Care Compare group NPD

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

• Mercy Health Partners

  • Critical Access Hospital
  • Shelby, MI
  • NPI 1285662981
  Care Compare affiliation
• Mercy Health Partners

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation
• Trinity Health Grand Haven Hospital

  • General Acute Care Hospital
  • Grand Haven, MI
  • NPI 1942379284
  Care Compare affiliation

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1174044259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 315A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425543",
            "telephone_number": "231-727-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CLINTON ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425502",
            "telephone_number": "231-728-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TRISTAN",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101023386",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101025356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly A Davis, PH.D.
• Kimberley Davis
• Margaret Anne Davis, LLMSW
• Tametria Davis, HHA
• Tanner Davis, D.O.
• Vanessa R Davis
• Vicki Davis, LPN
• Daybreak Adult Services Inc
• Sarah Daykin
• Dayspring Inc.

• Emergency Medicine Physician in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.