Martin A Davidson, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

201408 Issued in NY

Practice address

15 Degrandpre Way
Plattsburgh, NY 12901-6449

Phone

(518) 834-9310

Fax

(518) 834-1148

NPI assigned

Aug 7, 2006

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: mdavidson@premiermedicalhv.medentdirect.com

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.

• Premier Medical Group of the Hudson Valley P.C.

  • Urology Physician
  • Poughkeepsie, NY
  • NPI 1255437166
  Medicare reassignment NPD
• Premier Medical Group of the Hudson Valley, P.C.

  • Podiatrist
  • Wappingers Falls, NY
  • NPI 1467290130
  NPD
• Albert a. Bravo D.P.M.

  • Podiatrist
  • Pittsfield, MA
  • NPI 1073645024
  NPD

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1184633133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1479 HIGHLAND RD",
            "city": "KEESEVILLE",
            "state": "NY",
            "postal_code": "129442330",
            "telephone_number": "518-834-9310",
            "fax_number": "518-834-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DEGRANDPRE WAY",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016449",
            "telephone_number": "518-834-9310",
            "fax_number": "518-834-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MARTIN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "NY",
            "license": "201408",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "201408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sweta Das, OD
• Vicki Dauphinais, LMHC, CASAC 2
• Michael Thomas Davey, DMD, PH D
• David a Stone
• David P.Gorman, MD PC (Women's Health Center)
• Nancy Beth Davidson, RN
• Eileen E Davis Roesler, MS CCCA
• Barbara Davis-Meconi, R.N.
• Gordon H Davis, DMD,DMSC
• Jerome Alfred Davis, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Anatomic Pathology & Clinical Pathology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.