Individual provider Active NPI

Mohsen Davoudi, MD

  • Pulmonary Disease Physician
  • Stony Brook, NY
National Provider Identifier
1649472317
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
1026247 Issued in MA
Practice address
CPMP, HSC L5, RM 048, 100 Nicolls Road
Stony Brook, NY 11794-8552
Phone
(917) 414-9517
NPI assigned
Jun 4, 2007
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A86885 CA
Internal Medicine Physician 207R00000X 1026247 MA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 1026247 MA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A86885 CA
Pulmonary Disease Physician 207RP1001X A86885 CA
Pulmonary Disease Physician 207RP1001X 1026247 MA Primary

Addresses

Primary practice location

CPMP, HSC L5, RM 048, 100 Nicolls Road
Stony Brook, NY 11794-8552

Mailing address

960 Massachusetts Ave Ste 2
Boston, MA 02118-2690

Other practice location 1

725 Albany St Ste 9B
Boston, MA 02118-3549
Phone (617) 638-7480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071023000845 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Other (Physician) 7911804273 Reassigns benefits to 2 organizations
Practice locations: Rancho Mirage, CA
I20220613002805 NY Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7911804273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86885CAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Associates Corporation CurrentSince Apr 13, 2020 Accepting new patients
United Medical Group, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Pulmonary Disease CurrentSince Jun 1, 2022 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jun 1, 2022 Accepting new patients
HP Intensivist Medical Group, Inc Critical Care Medicine CurrentSince Mar 1, 2022 Accepting new patients

Locations

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

41750 Rancho Las Palmas Dr
Ste M3
Rancho Mirage, CA 92270
Phone (760) 895-4292

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

100 Nicolls Rd
Rm 48
Stony Brook, NY 11794
Phone (516) 444-2975

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • BSC 65 PLUS INDIVIDUAL MAPD
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mdavoudi51209@enloedirect.org
  • Direct secure messaging: mohsen.davoudi.p5@direct.mydohc.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1649472317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CPMP, HSC L5, RM 048, 100 NICOLLS ROAD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948552",
            "telephone_number": "917-414-9517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Albany St Ste 9B",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021183549",
            "country_code": "US",
            "telephone_number": "617-638-7480",
            "fax_number": "617-638-7486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVOUDI",
        "first_name": "MOHSEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A86885",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "1026247",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MA",
            "license": "1026247",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A86885",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A86885",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "1026247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.