Individual provider Active NPI

Jonathan N. Davila, MD

  • Psychiatry Physician
  • Rochester, NY
National Provider Identifier
1205333812
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
318697 Issued in NY
Practice address
224 Alexander St Ste 100
Rochester, NY 14607-4000
Phone
(585) 922-7770
NPI assigned
Apr 10, 2018
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 318697 NY Primary

Addresses

Primary practice location

224 Alexander St Ste 100
Rochester, NY 14607-4000

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-4221

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230713003053 NY Practitioner - Psychiatry 4486991544 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318697NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Jul 17, 2023 Accepting new patients
Rochester General Hospital CurrentSince Jul 17, 2023 Accepting new patients
Rochester General Hospital Psychiatry CurrentSince Jun 25, 2023 Accepting new patients
Rochester General Hospital PastSince Jun 25, 2023 Accepting new patients

Locations

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

224 Alexander St
Ste 100
Rochester, NY 14607
Phone (585) 922-7200

Interoperability endpoints

  • Direct secure messaging: jdavila371810@direct.rochesterregional.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1205333812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 ALEXANDER ST STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146074000",
            "telephone_number": "585-922-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 Grider St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142153021",
            "country_code": "US",
            "telephone_number": "716-898-4221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "JONATHAN",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "318697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.