NPIMap

Individual provider Active NPI

Raul E Davaro, M.D.

  • Infectious Disease Physician
  • Worcester, MA
National Provider Identifier
1538142161
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD478859 Issued in PA
Practice address
123 Summer Street Suite 220 S
Worcester, MA 01608-2903
Phone
(508) 368-3122
Fax
(508) 368-3123
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 79089 MA
Infectious Disease Physician 207RI0200X MD478859 PA Primary

Addresses

Primary practice location

123 Summer Street Suite 220 S
Worcester, MA 01608-2903

Mailing address

630 Plantation Street Wot 12TH FL
Worcester, MA 01605-2038
Phone (508) 368-3122

Other practice location 1

1255 S Cedar Crest Blvd Ste 2100
Allentown, PA 18103-6226
Phone (610) 402-8430

Other identifiers 1

IdentifierTypeStateIssuer
3172864MedicaidMA

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
I20221021000314 PA Practitioner - Infectious Disease 0749366367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1255 S Cedar Crest Blvd
2200 LVPG Internal Medicine
Allentown, PA 18103-6256
Phone (610) 402-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Oct 31, 2022 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 31, 2022 Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

1255 S Cedar Crest Blvd
Ste 2200
Allentown, PA 18103
Phone (610) 437-9006

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1255 S Cedar Crest Blvd
Ste 2100
Allentown, PA 18103
Phone (610) 402-3560

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Interoperability endpoints

  • Direct secure messaging: rdavaro712805@direct2.lvhn.org
  • Direct secure messaging: raul.davaro.npi1538142161.reliant@direct.optumcare.masshiway.net

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1538142161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION STREET WOT 12TH FL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-368-3122",
            "fax_number": "508-368-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER STREET SUITE 220 S",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016082903",
            "telephone_number": "508-368-3122",
            "fax_number": "508-368-3123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 S Cedar Crest Blvd Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036226",
            "country_code": "US",
            "telephone_number": "610-402-8430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVARO",
        "first_name": "RAUL",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "79089",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD478859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3172864",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.