Active NPI
John Michael Davidyock, MD
- Hospitalist Physician
- Winter Park, FL
National Provider Identifier
1417986159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- ME134454
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| ME134454 | FL | MD | Internal Medicine Physician |
| MD423640 | PA | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Physical Medicine & Rehabilitation Physician
- Chester, PA
- NPI 1356460380
-
- Family Medicine Physician
- East Stroudsburg, PA
- NPI 1245093368
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.