Samuel Davidson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2338730 Issued in MA

Practice address

6 Lexington St Ste 300
Waltham, MA 02452-4401

Phone

(978) 662-1002

Fax

(978) 767-4757

NPI assigned

Apr 13, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pratt Medical Group IncGroup PAC ID 3375515661, 282 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Pratt Medical Group, Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1275570319
  Medicare reassignment Care Compare group
• Core Care Clinic LLC

  • Internal Medicine Physician
  • North Andover, MA
  • NPI 1316784457

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1831885615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LEXINGTON ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024524401",
            "telephone_number": "978-662-1002",
            "fax_number": "978-767-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 LEXINGTON ST STE 300",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024524401",
            "telephone_number": "978-662-1002",
            "fax_number": "978-767-4757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Mill St",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "MA",
            "postal_code": "024781048",
            "country_code": "US",
            "telephone_number": "617-855-3280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "SAMUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-13",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2338730",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2338730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Daron, LICSW
• Rebecca Darrah
• Elizabeth Davenport, LICSW
• Leon David, MA
• Kathleen Rose Davidson, RNCS
• Aviva Davis
• Careyanne Dinisco Davis, PA-C
• Michelle Emery Davis, OTR/L
• Josette Camion Dawkins, M.D.
• Flavia De Castro Farias Lopes

• Psychiatric/Mental Health Nurse Practitioner in Waltham, MA
• Providers in Waltham, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.