Tatiana Davydova, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

029268 Issued in NY

Practice address

2792 Ocean Ave FL 2
Brooklyn, NY 11229-4731

Phone

(833) 635-2566

NPI assigned

Feb 7, 2023

Last updated

Dec 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Ji Medical PCGroup PAC ID 0749680395, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Ji Medical PC

  dba Kalon Dermatology

  • Clinic/Center
  • Brooklyn, NY
  • NPI 1366035248
  Medicare reassignment Care Compare group
• Josef Schenker MD PC

  dba Centers Urgent Care

  • Internal Medicine Physician
  • Middle Village, NY
  • NPI 1275936932
  Medicare reassignment

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1316644677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2792 OCEAN AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294731",
            "telephone_number": "833-635-2566",
            "fax_number": "833-635-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2792 OCEAN AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294731",
            "telephone_number": "833-635-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVYDOVA",
        "first_name": "TATIANA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7658395",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yelena Davydov, MD
• Yury Davydov
• Diana Davydova, FNP
• Dianna Davydova
• Mazol Davydova, OTR/L
• Yelena Davydova, DO
• Yuliya Davydova
• Angelina Dawes
• Mildred Dawes
• Brody James Dawkins, MD

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.