Active NPI
Ronald Jay Davidoff, M.D.
- Child & Adolescent Psychiatry Physician
- Enfield, CT
National Provider Identifier
1447366455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 034586
- Practice address
- 153 Hazard Ave
Enfield, CT 06082-4592 - Phone
- (860) 253-5020
- Fax
- (860) 253-5030
- NPI assigned
- Aug 22, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 034586 | CT | |
| Psychiatry Physician | 2084P0800X | 52805 | MA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 034586 | CT | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 52805 | MA |
Addresses
Primary practice location
153 Hazard Ave
Enfield, CT 06082-4592
Mailing address
2 Burnett St
Granby, MA 01033-3312
Phone (413) 536-3520
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0023796 | Other | MA | NEIGHBORHOOD HEALTH PLAN# |
| 6178537 | Other | MA | MASS HEALTH NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Georgetown University School of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
85 Post Office Park
Suite 8501 B
Wilbraham, MA 01095-1247
Phone (413) 583-6750
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034586 | CT | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Valley Counseling Center, Inc | Current | Accepting new patients |
Locations
303 Beech St
Holyoke, MA 01040
Phone (413) 540-1155
Interoperability endpoints
- ronald.davidoff.1@2941.direct.athenahealth.com
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Holyoke, MA
- NPI 1851444616
-
- Psychiatry Physician
- Wilbraham, MA
- NPI 1598770984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1447366455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 BURNETT ST",
"city": "GRANBY",
"state": "MA",
"postal_code": "010333312",
"telephone_number": "413-536-3520",
"fax_number": "860-253-5030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 HAZARD AVE",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060824592",
"telephone_number": "860-253-5020",
"fax_number": "860-253-5030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDOFF",
"first_name": "RONALD",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "034586",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "52805",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CT",
"license": "034586",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "52805",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN#",
"identifier": "0023796",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS HEALTH NUMBER",
"identifier": "6178537",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.