Active NPI
Thomas Patrick Davis, MD
- Cardiovascular Disease Physician
- St Clair Shores, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 4301050818
- Practice address
- 24211 Little Mack Ave
St Clair Shores, MI 48080-1190 - Phone
- (586) 498-0440
- Fax
- (586) 498-0401
- NPI assigned
- May 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 4301050818 | MI | Primary |
Addresses
Primary practice location
24211 Little Mack Ave
St Clair Shores, MI 48080-1190
Mailing address
24211 Little Mack Ave
St Clair Shores, MI 48080-1190
Phone (586) 498-0440
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10 | Other | MI | 10 |
| 3381359 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tdavis31521@direct.beaumont.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22720 Michigan Ave
Suite 300
Dearborn, MI 48124-2035
Phone (313) 791-3000
24211 Little Mack Ave
Saint Clair Shores, MI 48080-1151
Phone (810) 498-0440
30229 Schoenherr Rd
Warren, MI 48088-6858
Phone (586) 573-7971
Hospital & facility affiliations
- Henry Ford Health St John Hospital
- Henry Ford Health Warren Hospital
- Beaumont Hospital - Grosse Pointe
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.31 of 100
- Quality
- 66.77
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.8
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 14 |
| Varicose vein removal | 1-10 |
| Leg revascularization (restoring blood flow) | 70 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ankem Ravindra MD PA | Cardiovascular Disease | Current | Accepting new patients |
| Henry Ford Health St. John Hospital | Current | Accepting new patients | |
| Eastlake Cardiovascular PC | Cardiovascular Disease | Current | Accepting new patients |
| Henry Ford Health St. John Hospital | Current | Accepting new patients | |
| Henry Ford Health St. John Hospital | Cardiovascular Disease | Current | Accepting new patients |
| Halo Medical Group PLLC | Cardiovascular Disease | Current | Accepting new patients |
| MVP Endovascular Center PLLC | Cardiovascular Disease | Current | Accepting new patients |
Locations
1211 SW Bascom Norris Dr
Lake City, FL 32025
Phone (386) 326-3633
15101 Southfield Rd
Allen Park, MI 48101
Phone (313) 386-3996
22720 Michigan Ave
Ste 200
Dearborn, MI 48124
Phone (313) 791-3000
22720 Michigan Ave
Ste 300
Dearborn, MI 48124
Phone (313) 791-3000
22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248
7633 E Jefferson Ave
Ste 250
Detroit, MI 48214
Phone (313) 581-2121
4160 John R St
Ste 510
Detroit, MI 48201
Phone (313) 993-7777
46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269
25990 Kelly Rd
Ste 3
Roseville, MI 48066
Phone (586) 533-2639
20240 W 12 Mile Rd
Southfield, MI 48076
Phone (248) 331-1400
24211 Little Mack Ave
St Clr Shores, MI 48080
Phone (586) 498-0440
30229 Schoenherr Rd
Warren, MI 48088
Phone (586) 573-7971
4020 Venoy Rd
Ste 200
Wayne, MI 48184
Phone (734) 729-1900
Interoperability endpoints
- tdavis31521@direct.beaumont.edu
- tdavis1124671@direct.hfhs.org
Organizations & group practices 7
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.
-
- Cardiovascular Disease Physician
- St Clair Shores, MI
- NPI 1982657474
-
- Cardiovascular Disease Physician
- Detroit, MI
- NPI 1811214489
-
- Cardiovascular Disease Physician
- Dearborn, MI
- NPI 1194202234
-
- Podiatrist
- Harrison Township, MI
- NPI 1043478910
-
- Cardiovascular Disease Physician
- Lake City, FL
- NPI 1427380823
-
- Cardiovascular Disease Physician
- Detroit, MI
- NPI 1396876256
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1023088168
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Warren, MI
- NPI 1124099858
-
- General Acute Care Hospital
- Madison Heights, MI
- NPI 1215139233
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1811044878
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1023088168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1184673303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24211 LITTLE MACK AVE",
"city": "ST CLAIR SHORES",
"state": "MI",
"postal_code": "480801190",
"telephone_number": "586-498-0440",
"fax_number": "586-498-0401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24211 LITTLE MACK AVE",
"city": "ST CLAIR SHORES",
"state": "MI",
"postal_code": "480801190",
"telephone_number": "586-498-0440",
"fax_number": "586-498-0401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "THOMAS",
"middle_name": "PATRICK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-06",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MI",
"license": "4301050818",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "10",
"identifier": "10",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3381359",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tdavis31521@direct.beaumont.edu",
"affiliation": "N",
"address_1": "24211 Little Mack Ave",
"city": "St Clair Shores",
"state": "MI",
"country_code": "US",
"postal_code": "480801190",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in St Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.