Individual provider Active NPI

Kevin August Davis, MD

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1346403672
Registry record updated Mar 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
263380 Issued in NY
Practice address
200 W 13TH St FL 4
New York, NY 10011-7702
Phone
(929) 292-3700
Fax
(646) 465-3203
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A118400 CA
Anesthesiology Physician 207L00000X 263380 NY Primary

Addresses

Primary practice location

200 W 13TH St FL 4
New York, NY 10011-7702

Mailing address

480 Bedford Rd Ste 4202
Chappaqua, NY 10514-1716
Phone (914) 666-8866

Other practice location 1

1400 Pelham Pkwy S
Building 1, 12th Floor, Room 1226
Bronx, NY 10461-1197
Phone (718) 918-6864

Other practice location 2

3424 Kossuth Ave Rm 4E03
Bronx, NY 10467-2489
Phone (718) 519-3062

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230407000157 NY Practitioner - Anesthesiology 9537468806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A118400CAMDAnesthesiology Physician
263380NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Feb 15, 2023 Accepting new patients
Medical Ancillary Services, PLLC Anesthesiology PastSince Mar 12, 2023 Accepting new patients

Locations

480 Bedford Rd
Ste 4202
Chappaqua, NY 10514
Phone (914) 244-8762

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

200 W 13th St
Fl 4
New York, NY 10011
Phone (212) 289-0171

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677974400000",
    "number": "1346403672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 BEDFORD RD STE 4202",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105141716",
            "telephone_number": "914-666-8866",
            "fax_number": "914-666-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 13TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117702",
            "telephone_number": "929-292-3700",
            "fax_number": "646-465-3203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Pelham Pkwy S",
            "address_2": "Building 1, 12th Floor, Room 1226",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611197",
            "country_code": "US",
            "telephone_number": "718-918-6864",
            "fax_number": "718-918-7902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3424 Kossuth Ave Rm 4E03",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672489",
            "country_code": "US",
            "telephone_number": "718-519-3062",
            "fax_number": "718-519-3067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KEVIN",
        "middle_name": "AUGUST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A118400",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "263380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.