Organization Active NPI

Davda Medical Group LLC

  • Obstetrics & Gynecology Physician
  • Piscataway, NJ
National Provider Identifier
1619225455
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA07847200 Issued in NJ
Legal business name
DAVDA MEDICAL GROUP LLC
Practice address
1100 Centennial Ave Ste 201
Piscataway, NJ 08854-4152
Phone
(732) 956-7455
NPI assigned
Aug 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Authorized official

Name
Dr. Niyati Davda, MDNPI 1659346419
Title
Owner
Phone
(732) 956-7455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 25MA07847200 NJ Primary

Addresses

Primary practice location

1100 Centennial Ave Ste 201
Piscataway, NJ 08854-4152

Mailing address

1100 Centennial Ave Ste 201
Piscataway, NJ 08854-4152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140730002660 NJ Part B Supplier - Clinic/Group Practice 9830315670 Receives reassigned benefits from 1 practitioner
Practice locations: Piscataway, NJ

National Provider Directory

National Provider Directory

Locations

1100 Centennial Ave
Ste 201
Piscataway, NJ 08854
Phone (732) 474-0909

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1619225455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CENTENNIAL AVE STE 201",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088544152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTENNIAL AVE STE 201",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088544152",
            "telephone_number": "732-956-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVDA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "DAVDA",
        "authorized_official_first_name": "NIYATI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-956-7455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA07847200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piscataway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.