Active NPI
Matthew William Davis, M.D., R.PH.
- Urology Physician
- New York, NY
National Provider Identifier
1639475346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 237105
- Practice address
- 580 5TH Ave Ste 820
New York, NY 10036-4762 - Phone
- (267) 261-5887
- NPI assigned
- Jan 28, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 237105 | NY | Primary |
| Clinical Pharmacology Physician | 208U00000X | 237105 | NY |
Addresses
Primary practice location
580 5TH Ave Ste 820
New York, NY 10036-4762
Mailing address
576 Fifth Ave
Suite 903
New York, NY 10036
Phone (267) 261-5882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 237105 | NY | MD | Clinical Pharmacology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662854400000",
"number": "1639475346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 FIFTH AVE",
"address_2": "SUITE 903",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10036",
"telephone_number": "267-261-5882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 5TH AVE STE 820",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100364762",
"telephone_number": "267-261-5887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MATTHEW",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D., R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-28",
"last_updated": "2022-09-11",
"certification_date": "2022-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "237105",
"primary": true
},
{
"code": "208U00000X",
"taxonomy_group": "",
"desc": "Clinical Pharmacology",
"state": "NY",
"license": "237105",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.