Individual provider Active NPI

Matthew D Davidson, DO

  • Surgery Physician
  • State College, PA
National Provider Identifier
1689663775
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
05010824L Issued in PA
Practice address
164 Greenview Dr Ste 345
State College, PA 16803-2106
Phone
(814) 234-7599
Fax
(814) 237-2126
NPI assigned
Oct 20, 2005
Last updated
Jun 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 05010824L PA Primary

Addresses

Primary practice location

164 Greenview Dr Ste 345
State College, PA 16803-2106

Mailing address

155 Wellness Way
State College, PA 16803-6702
Phone (814) 231-7000

Other practice location 1

875 S Arlington Ave
Harrisburg, PA 17109-5004
Phone (717) 652-1107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040719001375 PA Practitioner - General SurgeryPractitioner - Other (Physician) 9032198387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

129 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-3626

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

143 Hospital Dr
State College, PA 16803-5500
Phone (814) 237-3470

155 Wellness Way
State College, PA 16803-6702

164 Greenview Dr
State College, PA 16803-2106
Phone (844) 278-4600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Colonoscopy1-10
Hernia repair - groin (open)14
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05010824LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc Surgery CurrentSince Jun 24, 2016 Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

1061 N Front St
Ste 2
Philipsburg, PA 16866
Phone (814) 231-7888

120 Radnor Rd
Ste 100
State College, PA 16801
Phone (814) 231-7125

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

164 Greenview Dr
State College, PA 16803
Phone (814) 237-4321

164 Greenview Dr
Ste 345
State College, PA 16803
Phone (814) 234-7599

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

905 University Dr
State College, PA 16801
Phone (814) 237-3122

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1689663775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WELLNESS WAY",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036702",
            "telephone_number": "814-231-7000",
            "fax_number": "814-231-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 GREENVIEW DR STE 345",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032106",
            "telephone_number": "814-234-7599",
            "fax_number": "814-237-2126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 S Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171095004",
            "country_code": "US",
            "telephone_number": "717-652-1107",
            "fax_number": "717-652-1142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "05010824L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.