Active NPI
Scott B Davidson, MD
- Surgery Physician
- Traverse City, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4301056087
- Practice address
- 1105 Sixth St
Traverse City, MI 49684-2345 - Phone
- (231) 935-7514
- Fax
- (231) 392-0039
- NPI assigned
- Jan 19, 2006
- Last updated
- Sep 27, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301056087 | MI | Primary |
Addresses
Primary practice location
1105 Sixth St
Traverse City, MI 49684-2345
Mailing address
601 John St
Suite M452
Kalamazoo, MI 49007-5341
Phone (269) 341-6022
Other practice location 1
1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone (231) 935-2400
Other practice location 2
601 John St
Suite M452
Kalamazoo, MI 49007-5341
Phone (269) 341-6022
Other practice location 3
4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA2184 | Other | MI | RAILROAD MEDICARE |
| 4575043 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@direct.bronsonhg.org | Direct | Bronson Healthcare Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Wayne State University School of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-7514
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.43 of 100
- Quality
- 75.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.38
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munson Medical Center | Current | Accepting new patients | |
| Munson Medical Center | Current | Accepting new patients | |
| Acute Care Surgery Medical Group, Inc. | Surgery | Current | Accepting new patients |
| Munson Medical Center | Current | Accepting new patients | |
| Munson Medical Center | Past | Accepting new patients |
Locations
2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031
416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000
50 N Perry St
#2
Pontiac, MI 48342
Phone (248) 338-5865
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
1221 Sixth St
Ste 100
Traverse City, MI 49684
Phone (231) 392-8400
1221 Sixth St
Ste 300
Traverse City, MI 49684
Phone (231) 392-0640
1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000
4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900
Ownership & related parties
All facility ownership & control disclosures 4
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Bronson Lakeview Hospital | Hospital | Corporate Director | Sep 22, 2016 |
| Bronson South Haven Hospital | Hospital | Corporate Director | Jan 1, 2017 |
| Bronson Lakeview Hospital | Hospital | Corporate Director | Sep 22, 2016 |
| Bronson Lakeview Family Care-Paw Paw | Rural health clinic | Corporate Director | Sep 22, 2016 |
Owned or controlled facilities with NPI records 3
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Bronson Lakeview Family Care-Paw Paw
- Rural Health Clinic/Center
- Paw Paw, MI
- NPI 1356565170
Corporate Director
-
- General Acute Care Hospital
- South Haven, MI
- NPI 1346275856
Corporate Director
Organizations & group practices 6
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.
-
dba Endocrinology and Metabolism
- Endocrinology, Diabetes & Metabolism Physician
- Traverse City, MI
- NPI 1083761860
-
dba Bronson Medical Group
- Hospitalist Physician
- Kalamazoo, MI
- NPI 1417961137
-
- Internal Medicine Physician
- Traverse City, MI
- NPI 1508390741
-
- Psychiatric Hospital Unit
- Traverse City, MI
- NPI 1891586103
-
dba Urgent Care-UCN
- Family Medicine Physician
- Traverse City, MI
- NPI 1881623031
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Traverse City, MI
- NPI 1952307852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1811977424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 JOHN ST",
"address_2": "SUITE M452",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490075341",
"telephone_number": "269-341-6022",
"fax_number": "269-341-8244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 SIXTH ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842345",
"telephone_number": "231-935-7514",
"fax_number": "231-392-0039"
}
],
"practiceLocations": [
{
"address_1": "1221 Sixth St Ste 300",
"address_purpose": "LOCATION",
"city": "Traverse City",
"state": "MI",
"postal_code": "496842360",
"country_code": "US",
"telephone_number": "231-935-2400",
"fax_number": "231-392-2424",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "601 John St",
"address_2": "Suite M452",
"address_purpose": "LOCATION",
"city": "Kalamazoo",
"state": "MI",
"postal_code": "490075341",
"country_code": "US",
"telephone_number": "269-341-6022",
"fax_number": "269-341-8244",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4100 Park Forest Dr",
"address_purpose": "LOCATION",
"city": "Traverse City",
"state": "MI",
"postal_code": "496847331",
"country_code": "US",
"telephone_number": "231-392-8900",
"fax_number": "231-392-8973",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIDSON",
"first_name": "SCOTT",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301056087",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CA2184",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4575043",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct@direct.bronsonhg.org",
"affiliation": "Y",
"endpointDescription": "Bronson Healthcare Group Direct address",
"affiliationName": "Bronson Healthcare Group",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Continuity of Care Document",
"address_1": "601 John St",
"city": "Kalamazoo",
"state": "MI",
"country_code": "US",
"postal_code": "490075341",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.