Individual provider Active NPI

Beverly Davison, MD

  • Emergency Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1720029820
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MA06639300 Issued in NJ
Practice address
30 Prospect Ave
Etd
Hackensack, NJ 07601-1914
Phone
(201) 996-4614
Fax
(201) 968-1866
NPI assigned
Jun 9, 2006
Last updated
Jul 13, 2026By the provider in NPPES
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
Emergency Medicine Physician 207P00000X MA06639300 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Etd
Hackensack, NJ 07601-1914

Mailing address

11 Pheasant Run
Englewood, NJ 07631-5043
Phone (201) 996-4614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20101015000792 NJ Practitioner - Emergency Medicine 1153514633 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
70.61 of 100Reported as individual
Quality
55.21
Improvement activities
40
Cost
67.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA06639300NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metrodoc Healthcare LLC CurrentSince May 21, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 15, 1997 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 15, 1997 Accepting new patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Aug 15, 2015 Accepting new patients
Compassion Medical Group PC CurrentSince Jun 18, 2023 Accepting new patients
Njucare LLC CurrentSince May 14, 2023 Accepting new patients
Riverview Medical Care Corp CurrentSince Jun 18, 2023 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

365 Convery Blvd
Ste 14
Perth Amboy, NJ 08861
Phone (973) 310-7000

97 W Parkway
Pompton Plns, NJ 07444
Phone (973) 831-5000

141 Chestnut St
Ste 201
Roselle Park, NJ 07204
Phone (973) 210-4000

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24140/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720029820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PHEASANT RUN",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076315043",
            "telephone_number": "201-996-4614",
            "fax_number": "201-968-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "ETD",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011914",
            "telephone_number": "201-996-4614",
            "fax_number": "201-968-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "BEVERLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MA06639300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.