Individual provider Active NPI

Thomas Patrick Davis, MD

  • Cardiovascular Disease Physician
  • St Clair Shores, MI
National Provider Identifier
1184673303
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301050818 Issued in MI
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

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
10OtherMI10
3381359MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tdavis31521@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20080908000461 MI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5991693491 Reassigns benefits to 4 organizations
I20251009000918 FL Practitioner - Internal Medicine 5991693491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVP Endovascular Center PLLCGroup PAC ID 7315297827, 6 clinicians
Eastlake Cardiovascular PCGroup PAC ID 4688562176, 22 clinicians
Halo Medical Group PLLCGroup PAC ID 1850587890, 17 clinicians

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 Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089

Merit-based Incentive Payment System (MIPS)

Final score
86.31 of 100Reported as group
Quality
66.77
Promoting interoperability
100
Improvement activities
40
Cost
76.8

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting14
Varicose vein removal1-10
Leg revascularization (restoring blood flow)70

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ankem Ravindra MD PA Cardiovascular Disease CurrentSince Sep 1, 2025 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Eastlake Cardiovascular PC Cardiovascular Disease CurrentSince Oct 1, 1997 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Dec 1, 2012 Accepting new patients
Henry Ford Health St. John Hospital Cardiovascular Disease CurrentSince Dec 1, 2012 Accepting new patients
Halo Medical Group PLLC Cardiovascular Disease CurrentSince Dec 1, 2024 Accepting new patients
MVP Endovascular Center PLLC Cardiovascular Disease CurrentSince Feb 1, 2025 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

  • Direct secure messaging: tdavis31521@direct.beaumont.edu
  • Direct secure messaging: 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.

Hospital & facility affiliations 5

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": "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

Verify at the official NPI Registry.