Individual provider Active NPI

Alexander Davis, MD

  • Dermatology Physician
  • Panama City, FL
National Provider Identifier
1285160879
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME146532 Issued in FL
Practice address
425 W 19TH St Ste D&E
Panama City, FL 32405-4659
Phone
(850) 818-0220
Fax
(850) 818-0156
NPI assigned
May 3, 2017
Last updated
Jan 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME146532 FL Primary

Addresses

Primary practice location

425 W 19TH St Ste D&E
Panama City, FL 32405-4659

Mailing address

PO Box 13834
Tallahassee, FL 32317-3834
Phone (850) 205-6232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210604000483 FL Practitioner - Dermatology 1355740788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Florida State University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

425 W 19TH St D
Panama City, FL 32405-4631
Phone (850) 877-4134

Merit-based Incentive Payment System (MIPS)

Final score
89.59 of 100Reported as group
Quality
100
Promoting interoperability
91
Improvement activities
40
Cost
72.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision238
Removal of skin lesions1386
Removal or shaving of skin growth1-10
Skin biopsy514

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME146532FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Tallahassee PA Dermatology CurrentSince Jul 1, 2021 Accepting new patients
Dermatology Associates of Tallahassee, PA Dermatology CurrentSince Jul 1, 2021 Accepting new patients

Locations

19611 State Road 20 W
Blountstown, FL 32424
Phone (850) 674-5645

110 NE 5th St
Carrabelle, FL 32322
Phone (850) 697-1118

3009 4th St
Marianna, FL 32446
Phone (850) 526-3937

425 W 19th St
Ste D
Panama City, FL 32405

1707 Riggins Rd
Tallahassee, FL 32308
Phone (850) 205-6232

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1285160879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13834",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323173834",
            "telephone_number": "850-205-6232",
            "fax_number": "855-975-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 19TH ST STE D&E",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054659",
            "telephone_number": "850-818-0220",
            "fax_number": "850-818-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME146532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.