Individual provider Active NPI

Caitlyn Jean Davis, PA

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1689273245
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025828 Issued in NY
Practice address
10 Miracle Mile Dr
Rochester, NY 14623-5851
Phone
(585) 275-6201
NPI assigned
Oct 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 025828 NY Primary

Addresses

Primary practice location

10 Miracle Mile Dr
Rochester, NY 14623-5851

Mailing address

601 Elmwood Ave Box 665
Rochester, NY 14642-0001
Phone (585) 275-6201

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922000833 NY Practitioner - Physician Assistant 8527471077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopaedic Associates of RochesterGroup PAC ID 7012909161, 149 clinicians

Practice addresses (Care Compare)

10 Miracle Mile Dr
Rochester, NY 14623-5851
Phone (585) 275-5321

601 Elmwood Ave
Rochester, NY 14642-0001

601 Elmwood Ave Box
Rochester, NY 14642-0001
Phone (585) 275-5321

Hospital & facility affiliations

  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
025828NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopaedic Associates of Rochester CurrentSince Nov 1, 2021 Accepting new patients
University Orthopaedic Associates of Rochester CurrentSince Nov 1, 2021 Accepting new patients

Locations

10 Miracle Mile Dr
Rochester, NY 14623
Phone (585) 272-7240

4901 Lac de Ville Blvd
Bldg D
Rochester, NY 14618
Phone (585) 275-1395

601 Elmwood Ave
#665
Rochester, NY 14642
Phone (585) 275-5168

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1689273245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 665",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MIRACLE MILE DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146235851",
            "telephone_number": "585-275-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CAITLYN",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.