NPIMap

Individual provider Active NPI

Nicole L Davis, PA-C

  • Surgical Physician Assistant
  • Hartford, CT
National Provider Identifier
1265864730
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
003411 Issued in CT
Practice address
85 Seymour St
Suite 709
Hartford, CT 06106-5501
Phone
(860) 696-2290
Fax
(860) 696-2280
NPI assigned
Aug 6, 2013
Last updated
Feb 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 003411 CT Primary

Addresses

Primary practice location

85 Seymour St
Suite 709
Hartford, CT 06106-5501

Mailing address

85 Seymour St
Suite 709
Hartford, CT 06106-5501
Phone (860) 696-2290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160427002002 CT Practitioner - Physician Assistant 8628203940 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MHS Primary Care, Inc.Group PAC ID 4082507371, 180 clinicians

Practice addresses (Care Compare)

14 Jones Hollow Rd
Suite 2
Marlborough, CT 06447-1448
Phone (860) 358-2850

512 Saybrook Rd
Suite 100
Middletown, CT 06457-4788
Phone (860) 347-7636

540 Saybrook Rd
Middletown, CT 06457-4711
Phone (860) 358-5120

6 Greenwich Office Park
Greenwich, CT 06831-5151
Phone (203) 869-1145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.22 of 100Reported as group
Quality
82.55
Promoting interoperability
100
Improvement activities
40
Cost
64.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic & Neurosurgery Specialists, PLLC CurrentSince Oct 9, 2021 Accepting new patients
Orthopaedic & Neurosurgery Specialists, PLLC CurrentSince Oct 9, 2021 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Apr 1, 2016 Accepting new patients
MHS Primary Care Inc. Surgical CurrentSince Jul 28, 2020 Accepting new patients
MHS Primary Care, Inc Past Accepting new patients
Hartford Clinical Associates, PC Past Accepting new patients

Locations

6 Greenwich Office Park
Greenwich, CT 06831
Phone (203) 869-1145

85 Seymour St
Ste 709
Hartford, CT 06106
Phone (860) 696-2290

14 Jones Hollow Rd
Ste 2
Marlborough, CT 06447

14 Jones Hollow Rd
Ste 5
Marlborough, CT 06447
Phone (860) 295-8751

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

512 Saybrook Rd
Ste 100
Middletown, CT 06457
Phone (860) 704-6021

540 Saybrook Rd
Ste 100B
Middletown, CT 06457
Phone (860) 347-6683

52 Washington Ave
Ste 3
North Haven, CT 06473
Phone (860) 399-0245

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

5 Pequot Park Rd
Ste 202
Westbrook, CT 06498
Phone (860) 399-0245

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: ndavis@ons.emadirect.md
  • Direct secure messaging: nicole.linger@xdr.hhchealthdirect.org

Organizations & group practices 6

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 6

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": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1265864730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "SUITE 709",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065501",
            "telephone_number": "860-696-2290",
            "fax_number": "860-696-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "SUITE 709",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065501",
            "telephone_number": "860-696-2290",
            "fax_number": "860-696-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "003411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.