Ilya V Davidovich, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801087558 Issued in MI

Practice address

1001 S Raisinville Rd
Monroe, MI 48161-9754

Phone

(734) 384-0305

NPI assigned

Apr 11, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jewish Family Services of Washtenaw County IncGroup PAC ID 2769671106, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jewish Family Services of Washtenaw County, Inc.

  • Mental Health Counselor
  • Ann Arbor, MI
  • NPI 1558691162

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1790128494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 S IVANHOE AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481977113",
            "telephone_number": "734-484-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S RAISINVILLE RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619754",
            "telephone_number": "734-384-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOVICH",
        "first_name": "ILYA",
        "middle_name": "V",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurt Lee Dasher, O. D.
• William Dashner, LBSW, QMRP
• Brooke Ann Daum
• David F. Yentz, D.D.S., P.C.
• Edwin David, MD
• Barbara Ann Davies, M.D.
• Bradly Todd Davis, PT
• Robert Davis
• Erik Paul De Meulemeester, DSCPT
• Dearborn Physical Therapy LTD. (Advanced Physical Therapy)

• Clinical Social Worker in Monroe, MI
• Providers in Monroe, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.