Individual provider Active NPI

Andrew C Davidson, M.D.

  • Cardiovascular Disease Physician
  • Hartford, CT
National Provider Identifier
1255503769
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
52639 Issued in CT
Practice address
19 Woodland St
Suite 35
Hartford, CT 06105-2372
Phone
(860) 525-1234
Fax
(860) 278-8782
NPI assigned
Mar 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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 52639 CT Primary

Addresses

Primary practice location

19 Woodland St
Suite 35
Hartford, CT 06105-2372

Mailing address

19 Woodland St
Suite 35
Hartford, CT 06105-2372
Phone (860) 525-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20140505001806 CT Practitioner - Cardiovascular Disease (Cardiology) 1850524588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Columbia University College of Physicians and Surgeons, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLean FundGroup PAC ID 0648247403, 105 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208

19 Woodland St
Suite 43
Hartford, CT 06105-2335
Phone (860) 633-0500

381 Hopmeadow St
Suite 304
Weatogue, CT 06089-9697
Phone (860) 651-4358

75 Great Pond Rd
Simsbury, CT 06070-1980

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc Cardiovascular Disease CurrentSince Jul 1, 2014 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jul 1, 2014 Accepting new patients

Locations

1699 King St
Ste 404
Enfield, CT 06082
Phone (860) 651-4358

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

19 Woodland St
Ste 45
Hartford, CT 06105
Phone (860) 527-1669

19 Woodland St
Ste 35
Hartford, CT 06105
Phone 20321768760

Interoperability endpoints

  • Direct secure messaging: adavidson2377203@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1255503769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WOODLAND ST",
            "address_2": "SUITE 35",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052372",
            "telephone_number": "860-525-1234",
            "fax_number": "860-278-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WOODLAND ST",
            "address_2": "SUITE 35",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052372",
            "telephone_number": "860-525-1234",
            "fax_number": "860-278-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ANDREW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "52639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.