Individual provider Active NPI

Daniel Travis, MD

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1578093480
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
308230 Issued in NY
Practice address
1114 Liberty Ave
Brooklyn, NY 11208-2922
Phone
(718) 765-6058
Fax
(347) 808-4895
NPI assigned
Jun 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 308230 NY Primary

Addresses

Primary practice location

1114 Liberty Ave
Brooklyn, NY 11208-2922

Mailing address

PO Box 746087
Atlanta, GA 30374-6087
Phone (312) 733-9730

Other practice location 1

101 Saint Andrews Ln
Glen Cove, NY 11542-2254
Phone (516) 674-7631

Other practice location 2

195 Montague St
Brooklyn, NY 11201-3628
Phone (718) 422-8000

Other practice location 3

4708 5th Ave
Brooklyn, NY 11220-1210
Phone (718) 576-2959

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210125001008 NY Practitioner - Family Practice 9638423262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Myers Medical PCGroup PAC ID 5294145017, 78 clinicians

Practice addresses (Care Compare)

1114 Liberty Ave
Brooklyn, NY 11208-2922
Phone (718) 765-6058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
308230NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Jan 11, 2021 Accepting new patients
Griffin Myers Medical, P.C. Family Medicine CurrentSince Mar 31, 2025 Accepting new patients
Advantagecare Physicians PC Family Medicine CurrentSince Jan 11, 2021 Accepting new patients

Locations

455 Sutter Ave
Brooklyn, NY 11212
Phone (718) 765-6550

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

4708 5th Ave
Brooklyn, NY 11220
Phone (718) 576-2959

1114 Liberty Ave
Brooklyn, NY 11208
Phone (718) 765-6058

11515 Sutphin Blvd
Jamaica, NY 11434
Phone (718) 659-4000

55 Water St
Fl 2
New York, NY 10041

Networks

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

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 3

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1578093480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082922",
            "telephone_number": "718-765-6058",
            "fax_number": "347-808-4895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Saint Andrews Ln",
            "address_purpose": "LOCATION",
            "city": "Glen Cove",
            "state": "NY",
            "postal_code": "115422254",
            "country_code": "US",
            "telephone_number": "516-674-7631",
            "fax_number": "516-674-7639",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "195 Montague St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112013628",
            "country_code": "US",
            "telephone_number": "718-422-8000",
            "fax_number": "718-422-8265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4708 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112201210",
            "country_code": "US",
            "telephone_number": "718-576-2959",
            "fax_number": "718-228-4240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "308230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.