Active NPI
Melissa Davidson, MD
- Pediatric Adolescent Medicine Physician
- Englewood, NJ
National Provider Identifier
1467410043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- MA056284
- Practice address
- 370 Grand Avenue
Ste 203
Englewood, NJ 07631 - Phone
- (201) 568-3262
- Fax
- (201) 589-2634
- NPI assigned
- May 3, 2006
- Last updated
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA056284 | NJ | |
| Pediatric Adolescent Medicine Physician | 2080A0000X | MA056284 | NJ | Primary |
Addresses
Primary practice location
370 Grand Avenue
Ste 203
Englewood, NJ 07631
Mailing address
370 Grand Avenue
Ste 203
Englewood, NJ 07631
Phone (201) 568-3262
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BP169 | Other | OXFORD | |
| 4573706 | Medicaid | NJ |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA056284 | NJ | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocare LLC | Pediatrics | Past | Accepting new patients |
| Advocare, LLC | Pediatrics | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1467410043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "370 GRAND AVENUE",
"address_2": "STE 203",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "07631",
"telephone_number": "201-568-3262",
"fax_number": "201-589-2634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 GRAND AVENUE",
"address_2": "STE 203",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "07631",
"telephone_number": "201-568-3262",
"fax_number": "201-589-2634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MA056284",
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "NJ",
"license": "MA056284",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "BP169",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4573706",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Englewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.