Ira Davis, MD, PLLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

182268 Issued in NY

Legal business name

IRA DAVIS, MD, PLLC

Practice address

2627 Hylan Blvd # C
Box 10
Staten Island, NY 10314

Phone

(718) 477-4022

Fax

(718) 698-9573

NPI assigned

Mar 5, 2007

Last updated

Jul 24, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Wendy Mann

Title

Biller

Phone

(914) 774-2478

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Ira Davis MD PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ira Davis, MD, PLLC

  • MOHS-Micrographic Surgery Physician
  • Hartsdale, NY
  • NPI 1376679936
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ira C Davis, MD

  • Specialist
  • Hartsdale, NY
  • NPI 1912981507
  Medicare reassignment NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437696000000",
    "number": "1750410759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 N CENTRAL AVE",
            "address_2": "SUITE 114",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301832",
            "telephone_number": "914-288-0500",
            "fax_number": "914-288-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 HYLAN BLVD # C",
            "address_2": "BOX 10",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-477-4022",
            "fax_number": "718-698-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRA DAVIS, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-07-24",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "914-774-2478",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "182268",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "182268",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OH4223",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00221021",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID#",
            "identifier": "P2869871",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "3K2111",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Anthony Ippolito, OTD, OTR/L
• Nicole Ippolito
• Farhana Iqbal, M.D.
• Tooba Iqbal
• Ira Camhi, D.D.S., P.C.
• Christopher Irace
• Nadia Irfan
• Rejja Irfan, MD
• Irina Mesheriakov PT PC
• Irina's Kids Corp

• MOHS-Micrographic Surgery Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• MOHS-Micrographic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.