Individual provider Active NPI

Yuda Davydov, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1366192569
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
268326 Issued in AZ
Practice address
1311 E Muriel Dr
Phoenix, AZ 85022-2067
Phone
(917) 443-8114
NPI assigned
Mar 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 268326 AZ
Family Nurse Practitioner 363LF0000X 268326 AZ Primary

Addresses

Primary practice location

1311 E Muriel Dr
Phoenix, AZ 85022-2067

Mailing address

1311 E Muriel Dr
Phoenix, AZ 85022-2067

Other practice location 1

13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ydavydov387817@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20220429001293 AZ Practitioner - Nurse Practitioner 6002203619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aleracare Aic LLC CurrentSince Nov 7, 2022 Accepting new patients
Mayo Clinic Arizona CurrentSince Oct 25, 2024 Accepting new patients
Mayo Clinic Arizona CurrentSince Oct 25, 2024 Accepting new patients

Locations

2001 N 4th St
Flagstaff, AZ 86004
Phone (928) 526-5020

930 N Switzer Canyon Dr
Ste 201
Flagstaff, AZ 86001
Phone (520) 542-2125

3555 Western Ave
Kingman, AZ 86409
Phone (928) 530-5430

4045 E Bell Rd
Ste 157
Phoenix, AZ 85032
Phone (602) 404-0015

5350 E High St
Ste 300
Phoenix, AZ 85054
Phone (480) 716-5820

3100 N Navajo Dr
Ste B3
Prescott Valley, AZ 86314
Phone (480) 716-3476

3237 N Windsong Dr
Prescott Vly, AZ 86314
Phone (602) 680-0236

20185 E Ocotillo Rd
Ste 105
Queen Creek, AZ 85142
Phone (480) 677-3600

8952 E Desert Cove Ave
Ste 204
Scottsdale, AZ 85260
Phone (602) 971-6950

13400 E Shea Blvd
Scottsdale, AZ 85259

2120 W Ina Rd
Ste 100
Tucson, AZ 85741
Phone (520) 395-0471

2110 W 24th St
Ste A
Yuma, AZ 85364
Phone (855) 442-7700

Interoperability endpoints

  • Direct secure messaging: ydavydov387817@ehrdirect.mayoclinicmsg.org

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.

Hospital & facility affiliations 2

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1366192569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 E MURIEL DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850222067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 E MURIEL DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850222067",
            "telephone_number": "917-443-8114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852595499",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVYDOV",
        "first_name": "YUDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "268326",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "268326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ydavydov387817@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.