Robert Daniel Davis, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

POO312 Issued in CT

Practice address

2409 Main St
Bridgeport, CT 06606-5324

Phone

(203) 334-6955

Fax

(203) 334-2851

NPI assigned

Nov 3, 2006

Last updated

Oct 1, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Foot and Ankle Specialists LLCGroup PAC ID 6901183714, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincent's Medical Center Hospital, Bridgeport, CT, CCN 070028

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14824/brand/1/csg/1/fhir/r4
• Direct secure messaging: robert.davis.1@14824.direct.athenahealth.com
• Direct secure messaging: r.daniel.davis@xdr.hhchealthdirect.org

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.

• Family Foot & Ankle Specialists LLC

  • Foot & Ankle Surgery Podiatrist
  • Bridgeport, CT
  • NPI 1245774942
  Medicare reassignment Care Compare group NPD
• Neighborhood Health, Inc.

  dba HHC Neighborhood Health

  • General Practice Physician
  • Torrington, CT
  • NPI 1043544489
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SVMC Holdings, Inc

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1942224696
  Care Compare affiliation

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1801975537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065324",
            "telephone_number": "203-334-6955",
            "fax_number": "203-334-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065324",
            "telephone_number": "203-334-6955",
            "fax_number": "203-334-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "POO312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004070439",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "533669",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "Z5651",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "030000312CT02",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "001932",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1276009002",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Marie Davis, OTR/L
• Jacquelyn Davis
• John Davis, RN
• Juanita Davis, FNP-C
• Leila Diane Davis
• Umanga Dawlagala, MD.
• Day Physical Therapy Management LLC
• Patricia Esther De la Cruz Manzueta, LMSW
• Carolina De la Cruz-Andujar, R.D.H.
• Brian De la Rosa, M.D.

• Podiatrist in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.