Individual provider Active NPI

Allen B Davis, M.D.

  • Surgery Physician
  • Brighton, MA
National Provider Identifier
1861429003
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
39337 Issued in MA
Practice address
736 Cambridge St
Cardinal Cushing Pavilion, 6TH Floor
Brighton, MA 02135-2907
Phone
(617) 779-6800
Fax
(617) 779-6883
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 39337 MA Primary

Addresses

Primary practice location

736 Cambridge St
Cardinal Cushing Pavilion, 6TH Floor
Brighton, MA 02135-2907

Mailing address

77 Warren St
RM 339
Brighton, MA 02135-3601

Other identifiers 1

IdentifierTypeStateIssuer
2041022MedicaidMA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324000229 MA Practitioner - General Surgery 4284680141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Center at Tufts Medical Center IncGroup PAC ID 3870857816, 98 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue158
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Feb 1, 2012 Accepting new patients
Cardiovascular Center at Tufts Medical Center, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Feb 1, 2012 Accepting new patients
New England Chiropractic, LLC Past Accepting new patients
Signature Healthcare Medical Group Inc Surgery Past Accepting new patients
South Arkansas Physician Services LLC PastSince Oct 1, 2012 Accepting new patients

Locations

800 Washington St
#1
Boston, MA 02111

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

736 Cambridge St
Fl 6
Brighton, MA 02135
Phone (617) 779-6083

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

77 Warren St
Rm 339
Brighton, MA 02135
Phone (617) 562-5428

1 Pearl St
Ste 2700
Brockton, MA 02301
Phone (508) 584-4104

Interoperability endpoints

  • Direct secure messaging: adavis87983@tuftsmedicine.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1861429003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "address_2": "RM 339",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "address_2": "CARDINAL CUSHING PAVILION, 6TH FLOOR",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-779-6800",
            "fax_number": "617-779-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ALLEN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "39337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041022",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.