George Davydov

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

018986 Issued in NY

Practice address

14130 70TH Rd
Flushing, NY 11367-1937

Phone

(171) 826-3789

NPI assigned

Sep 16, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hudson Pro Orthopaedics and Sports MedicineGroup PAC ID 1557582327, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gdavydov70003@northwell.direct-ci.com

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.

• Hudson Pro Orthopaedics and Sports Medicine

  • Specialist
  • Hoboken, NJ
  • NPI 1023425279
  Medicare reassignment Care Compare group
• Icahn School of Medicine at Mount Sinai

  • Internal Medicine Physician
  • Astoria, NY
  • NPI 1477932275
  Medicare reassignment NPD
• Hudson Orthopedics PLLC

  • Specialist
  • New York, NY
  • NPI 1568204097
  Medicare reassignment
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• New York Metropolitan Orthopaedics and Spine, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • North Bergen, NJ
  • NPI 1326714148
  NPD (past)
• Roman Isaac MD PLLC

  • Orthopaedic Surgery Physician
  • Hoboken, NJ
  • NPI 1467819540
  NPD (past)

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1265801591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 WILLIAM ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382612",
            "telephone_number": "646-812-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14130 70TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671937",
            "telephone_number": "171-826-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVYDOV",
        "first_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-16",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "018986",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00542200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Mark Davis
• Chaya Davis
• Leighann Davis
• Nathan Davis, DO
• Boris Davydov
• Irina Davydova, OT
• Svetlana Davydova
• Tamara Davydova, FNP-BC, WCC, OMS
• Loraine Dawson, MOTR/L
• Day Day Up Adult Day Care Center Inc

• Surgical Physician Assistant in Flushing, NY
• Providers in Flushing, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.