NPIMap

Individual provider Active NPI

Stuart L Davidson, M.D.

  • Orthopaedic Surgery Physician
  • Bar Harbor, ME
National Provider Identifier
1205856341
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
018301 Issued in ME
Practice address
10 Wayman LN
Bar Harbor, ME 04609-1625
Phone
(207) 288-0242
Fax
(207) 288-9450
NPI assigned
Jul 20, 2006
Last updated
Mar 21, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 018301 ME Primary

Addresses

Primary practice location

10 Wayman LN
Bar Harbor, ME 04609-1625

Mailing address

10 Wayman LN
Bar Harbor, ME 04609-1625
Phone (207) 288-5081

Other identifiers 2

IdentifierTypeStateIssuer
1790764512-002MedicaidME
018301OtherMEME - LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100408000322 ME Practitioner - Orthopedic Surgery 5799685368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Georgetown University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Desert Island HospitalGroup PAC ID 0941250963, 61 clinicians

Practice addresses (Care Compare)

10 Wayman LN
Bar Harbor, ME 04609-1625
Phone 20728850811375

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.58 of 100Reported as apm
Quality
83.17
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Desert Island Hospital CurrentSince Mar 1, 2010 Accepting new patients
Mount Desert Island Hospital Orthopaedic Surgery CurrentSince Mar 1, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Mount Vernon Orthopaedics Assoc Orthopaedic Surgery PastSince Nov 11, 1996 Accepting new patients

Locations

10 Wayman Ln
Bar Harbor, ME 04609
Phone (207) 288-5082

322 Main St
Bar Harbor, ME 04609
Phone (207) 288-5082

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/b5eba017-85d4-4b6c-a2f0-9b2c7b0c38dd/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mount Desert Island HospitalBar Harbor, ME, CCN 20Z304 Hospital W-2 Managing Employee Jun 6, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 4

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1205856341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WAYMAN LN",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091625",
            "telephone_number": "207-288-5081",
            "fax_number": "207-288-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WAYMAN LN",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091625",
            "telephone_number": "207-288-0242",
            "fax_number": "207-288-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "STUART",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ME",
            "license": "018301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790764512-002",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ME - LICENSE",
            "identifier": "018301",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bar Harbor, ME

Sources for this page

Verify at the official NPI Registry.