Mark S. Davenport, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

173462 Issued in NY

Practice address

10 Hagen Dr
Suite 310
Rochester, NY 14625-2660

Phone

(585) 922-5840

Fax

(585) 586-7558

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Plastic Surgery Group of Rochester LLC

  • Plastic Surgery Physician
  • Rochester, NY
  • NPI 1053403717
  Medicare reassignment NPD
• TRW Aesthetic Associates, LLC

  • Specialist
  • Rochester, NY
  • NPI 1518059195
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1841217387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HAGEN DR",
            "address_2": "SUITE 310",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252660",
            "telephone_number": "585-922-5840",
            "fax_number": "585-586-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HAGEN DR",
            "address_2": "SUITE 310",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252660",
            "telephone_number": "585-922-5840",
            "fax_number": "585-586-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "MARK",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "173462",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NY",
            "license": "173462",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "173462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portia A Daughtry, RN
• Dianna Daunton, RN
• Jennifer Peters Dauphinee, LPN
• Carol Dauvergne, LCSW
• Karen G Davenport
• Michael Patrick Davenport
• William Davern, PA
• Christine Daves
• Jaclyn Christine Davey, L.A.C
• Katie Davey

• Plastic Surgery Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.