Individual provider Active NPI

John Michael Davidyock, MD

  • Hospitalist Physician
  • Winter Park, FL
National Provider Identifier
1417986159
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME134454 Issued in FL
Practice address
133 Benmore Dr Ste 200
Winter Park, FL 32792-4111
Phone
(407) 646-7070
Fax
(407) 646-7747
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME134454 FL
Hospitalist Physician 208M00000X MD423640 PA
Hospitalist Physician 208M00000X ME134454 FL Primary

Addresses

Primary practice location

133 Benmore Dr Ste 200
Winter Park, FL 32792-4111

Mailing address

133 Benmore Dr Ste 200
Winter Park, FL 32792-4111
Phone (407) 646-7070

Other practice location 1

1316 W Ontario St
Philadelphia, PA 19140-5220
Phone (215) 707-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME134454FLMDInternal Medicine Physician
MD423640PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Past Accepting new patients
Health Access Network Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1417986159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-646-7070",
            "fax_number": "407-646-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-646-7070",
            "fax_number": "407-646-7747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1316 W Ontario St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405220",
            "country_code": "US",
            "telephone_number": "215-707-1800",
            "fax_number": "215-707-3644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDYOCK",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME134454",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD423640",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME134454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.