Individual provider Active NPI

Alexis Davis, PA-C

  • Physician Assistant
  • Bethesda, MD
National Provider Identifier
1235248956
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0003297 Issued in MD
Practice address
8901 Wisconsin Ave
Bethesda, MD 20889-0004
Phone
(301) 319-8600
Fax
(301) 295-8716
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0003297 MD Primary

Addresses

Primary practice location

8901 Wisconsin Ave
Bethesda, MD 20889-0004

Mailing address

17105 Russet Dr
Bowie, MD 20716-3629
Phone (202) 255-9380

Other identifiers 2

IdentifierTypeStateIssuer
UNKNOWNMedicaidMD
363A00000XOtherPHYSICIAN ASSISTANT PA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230511001887 DC Practitioner - Physician Assistant 0446482921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Absolute Pain Management LLCGroup PAC ID 6103215850, 3 clinicians

Practice addresses (Care Compare)

6000 Executive Blvd
Suite 602
North Bethesda, MD 20852-3820
Phone (301) 770-6301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0003297MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SPRC, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alexis.davis.1@25225.direct.athenahealth.com

Organizations & group practices 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1235248956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17105 RUSSET DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163629",
            "telephone_number": "202-255-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-319-8600",
            "fax_number": "301-295-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ALEXIS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "UNKNOWN",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT PA",
            "identifier": "363A00000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.