Ethan Davoudzadeh, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

311958 Issued in NY

Practice address

1275 York Ave
New York, NY 10065-6007

Phone

(212) 639-2000

NPI assigned

Mar 18, 2019

Last updated

May 2, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Interventional RadiologyAlso: Diagnostic Radiology

Education

State University of New York Downstate Medical Center, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mskcc Radiology GroupGroup PAC ID 3971494683, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: edavoudzadeh34404@mskcc.direct-ci.com

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.

• Mskcc Radiology Group

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1639159692
  Medicare reassignment Care Compare group NPD
• Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey

  • Medical Oncology Physician
  • Basking Ridge, NJ
  • NPI 1184637886

  Vascular & Interventional Radiology

  Medicare reassignment NPD
• MSK Bergen

  • Medical Oncology Physician
  • Montvale, NJ
  • NPI 1558814657

  Vascular & Interventional Radiology

  Medicare reassignment NPD
• MSK Monmouth

  • Medical Oncology Physician
  • Middletown, NJ
  • NPI 1922459163

  Vascular & Interventional Radiology

  Medicare reassignment NPD

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

• Memorial Hospital for Cancer and Allied Diseases

  • General Acute Care Hospital
  • New York, NY
  • NPI 1700887411
  Care Compare affiliation
• Ralph Lauren Center for Cancer Care and Prevention

  • Special Hospital
  • New York, NY
  • NPI 1770046351
  Care Compare affiliation
• Memorial Hospital for Cancer & Allied Diseases

  • General Acute Care Hospital
  • Basking Ridge, NJ
  • NPI 1659385474
  Care Compare affiliation
• Memorial Sloan Kettering Bergen

  • General Acute Care Hospital
  • Montvale, NJ
  • NPI 1841650330
  Care Compare affiliation
• Memorial Sloan Kettering Monmouth

  • General Acute Care Hospital
  • Middletown, NJ
  • NPI 1528428521
  Care Compare affiliation

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1538628649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVOUDZADEH",
        "first_name": "ETHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "311958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daria Daviti, PHARMD
• Matthew Sontag Davitz, MD
• Nicole Davoodian
• Valerie Davoodzadeh
• Sara Davoudi, OTR
• Vijayalakshmi Phanipriyamva Davuluri, PT
• Arkadiy Davydov, PHARM D
• Julia Davydov
• Yuriy Davydov, MD
• Yuriy Davydov, PHARM D

• Vascular & Interventional Radiology Physician in New York, NY
• Providers in New York, NY by specialty
• Vascular & Interventional Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.

Verify at the official NPI Registry.