Individual provider Active NPI

Stephanie Alexis Davidoff, M.D. PH.D.

  • Psychiatry Physician
  • Wellesley, MA
National Provider Identifier
1669421236
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
76772 Issued in MA
Practice address
27 Mica LN
Suite 205
Wellesley, MA 02481-1724
Phone
(781) 751-1275
Fax
(781) 235-7912
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 76772 MA Primary

Addresses

Primary practice location

27 Mica LN
Suite 205
Wellesley, MA 02481-1724

Mailing address

76 Whitney St
Sherborn, MA 01770-1006
Phone (508) 653-8398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040628001338 MA Practitioner - Psychiatry 5294711404

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76772MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Community Care, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669421236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 WHITNEY ST",
            "city": "SHERBORN",
            "state": "MA",
            "postal_code": "017701006",
            "telephone_number": "508-653-8398",
            "fax_number": "508-655-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MICA LN",
            "address_2": "SUITE 205",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024811724",
            "telephone_number": "781-751-1275",
            "fax_number": "781-235-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOFF",
        "first_name": "STEPHANIE",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "M.D. PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "76772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.