Individual provider Active NPI

Moriah Davis, PHYSICIAN ASSISTANT

  • Physician Assistant
  • New York, NY
National Provider Identifier
1568013415
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
110 E 55TH St FL 14
New York, NY 10022-4585
Phone
(212) 283-3000
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

110 E 55TH St FL 14
New York, NY 10022-4585

Mailing address

1107 Park Ave
New York, NY 10128-1236
Phone (212) 722-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191218000779 NY Practitioner - Physician Assistant 1759715188 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schweiger Dermatology PLLCGroup PAC ID 5991947160, 254 clinicians

Practice addresses (Care Compare)

2500 Western Ave
Altamont, NY 12009-9485
Phone (518) 690-0177

2508 Western Ave
Altamont, NY 12009-9485
Phone (518) 690-0177

4535 Southwestern Blvd
Suite 202
Hamburg, NY 14075-1861
Phone (212) 283-3000

65 Broadway
Suite 1800
New York, NY 10006-2549
Phone (212) 283-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024190NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Nov 15, 2019 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jan 1, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Nov 15, 2019 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

2532 Grand Concourse
Bronx, NY 10458
Phone (718) 960-1500

50 Water St
Fl 3
New York, NY 10004

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

227 Madison St
New York, NY 10002
Phone (212) 238-7000

Networks

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

Interoperability endpoints

  • Direct secure messaging: mdavis847396@nychhc.direct-ci.com
  • Direct secure messaging: moriah.davis@schweigerderm.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1568013415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281236",
            "telephone_number": "212-722-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 55TH ST FL 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224585",
            "telephone_number": "212-283-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MORIAH",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.