Individual provider Active NPI

Michael Lee Davidov

  • Durable Medical Equipment & Medical Supplies
  • Brooklyn, NY
National Provider Identifier
1255892501
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Practice address
159 Whitman Dr
Brooklyn, NY 11234-6702
Phone
(917) 400-0410
NPI assigned
Mar 28, 2019
Last updated
Mar 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Dialysis Equipment & Supplies (DME) 332BD1200X NU
Nursing Facility Supplies (DME) 332BN1400X NU
Oxygen Equipment & Supplies (DME) 332BX2000X NU

Addresses

Primary practice location

159 Whitman Dr
Brooklyn, NY 11234-6702

Mailing address

159 Whitman Dr
Brooklyn, NY 11234-6702
Phone (917) 400-0410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1255892501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 WHITMAN DR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346702",
            "telephone_number": "917-400-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 WHITMAN DR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346702",
            "telephone_number": "917-400-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOV",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.