Active NPI
Frida Davydov
- Physician Assistant
- Jamaica, NY
National Provider Identifier
1689066524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 018485
- Practice address
- 8268 164TH St
Jamaica, NY 11432-1121 - Phone
- (718) 883-4054
- NPI assigned
- Mar 2, 2015
- Last updated
- Dec 3, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 018485 | NY | Primary |
Addresses
Primary practice location
8268 164TH St
Jamaica, NY 11432-1121
Mailing address
8268 164TH St
Jamaica, NY 11432-1121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160616000749 | NY | Order and Referring Only - Physician Assistant | 5890086185 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018485 | NY | MD | Physician Assistant |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575331200000",
"number": "1689066524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8268 164TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114321121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8268 164TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114321121",
"telephone_number": "718-883-4054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVYDOV",
"first_name": "FRIDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-02",
"last_updated": "2019-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "018485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.