NPIMap

Individual provider Active NPI

Juan Elias Davila, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Beaumont, TX
National Provider Identifier
1609850429
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
H4898 Issued in TX
Practice address
3650 Laurel St
Beaumont, TX 77707-2216
Phone
(409) 838-0346
NPI assigned
Dec 5, 2005
Last updated
Jul 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X H4898 TX Primary

Addresses

Primary practice location

3650 Laurel St
Beaumont, TX 77707-2216

Mailing address

3650 Laurel St
Beaumont, TX 77707-2216
Phone (409) 838-0346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100625000362 TX Practitioner - Physical Medicine and Rehabilitation 0042252330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.31 of 100Reported as group
Quality
74.88
Improvement activities
40
Cost
73.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H4898TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Bone & Joint Institute, PA Physical Medicine & Rehabilitation CurrentSince Apr 20, 1998 Accepting new patients

Locations

3460 Dowlen Rd
Beaumont, TX 77706
Phone (409) 838-0346

3650 Laurel St
Beaumont, TX 77707
Phone (409) 838-0346

2927 Park Plaza Ln
Port Arthur, TX 77642
Phone (409) 883-3744

Interoperability endpoints

  • Direct secure messaging: juandavila@bbj.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kate Dishman Rehabilitation HospitalBeaumont, TX, CCN 673030 Hospital Limited Partnership Interest (2.76%) Jul 14, 2006

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Organizations & group practices 1

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1609850429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 LAUREL ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777072216",
            "telephone_number": "409-838-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 LAUREL ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777072216",
            "telephone_number": "409-838-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "JUAN",
        "middle_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "H4898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.