Individual provider Active NPI

Katharine S. Davidoff, M.D.

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1285020990
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
275089 Issued in MA
Practice address
175 Cambridge St
Boston, MA 02114-2743
Phone
(617) 724-2911
NPI assigned
Apr 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 275089 MA Primary

Addresses

Primary practice location

175 Cambridge St
Boston, MA 02114-2743

Mailing address

175 Cambridge St
Boston, MA 02114-2743
Phone (176) 724-2911

Other practice location 1

55 Lake Ave N
Worcester, MA 01655
Phone (747) 442-5545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180808002854 MA Practitioner - Pediatric MedicinePractitioner - Hospice/Palliative Care 9133438096 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
275089MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Pediatrics CurrentSince Jul 1, 2020 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2020 Accepting new patients

Locations

175 Cambridge St
Ste 523
Boston, MA 02114

175 Cambridge St
Boston, MA 02114
Phone (617) 523-7006

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: davidoff.katharine.mgh@direct.partners.masshiway.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1285020990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142743",
            "telephone_number": "176-724-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142743",
            "telephone_number": "617-724-2911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01655",
            "country_code": "US",
            "telephone_number": "747-442-5545",
            "fax_number": "774-443-7042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDOFF",
        "first_name": "KATHARINE",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "275089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.