NPIMap

Individual provider Active NPI

Brenden Davis, DPM

  • Podiatrist
  • Wyomissing, PA
National Provider Identifier
1457923476
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC007180 Issued in PA
Practice address
1981 State Hill Rd
Wyomissing, PA 19610-1605
Phone
(610) 670-2277
NPI assigned
Jul 12, 2021
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC007180 PA Primary

Addresses

Primary practice location

1981 State Hill Rd
Wyomissing, PA 19610-1605

Mailing address

3605 Orchard View Rd
Reading, PA 19606-3921
Phone (301) 502-8460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709003888 PA Practitioner - Podiatry 5597129668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Foot and Ankle Associates PCGroup PAC ID 7315098662, 3 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

1981 State Hill Rd
Wyomissing, PA 19610-1605
Phone 61067022772

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

321 N Furnace St
Birdsboro, PA 19508-2057
Phone (610) 582-2250

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue18
Removal of nail tissue121
Removal or shaving of skin growth21
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC007180PAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Foot & Ankle Associates PC Podiatrist CurrentSince Jul 22, 2024 Accepting new patients
Carim Eye and Retina Center LTD. P.C. PastSince May 7, 2024 Accepting new patients

Locations

1981 State Hill Rd
Wyomissing, PA 19610
Phone (610) 378-2160

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1457923476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 ORCHARD VIEW RD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196063921",
            "telephone_number": "301-502-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 STATE HILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101605",
            "telephone_number": "610-670-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRENDEN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC007180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.