David Peter Gavin, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036117672 Issued in IL

Practice address

110 E Broward Blvd Ste 1700
Fort Lauderdale, FL 33301-3500

Phone

(224) 269-2200

NPI assigned

Jul 26, 2007

Last updated

Jun 29, 2021By 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 13, 2020 through Apr 13, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Gavin Psychiatry, LLC

  • Psychiatry Physician
  • Fort Lauderdale, FL
  • NPI 1497371843
  NPD Authorized official
• Oak Forest Psychological Service

  • Clinical Psychologist
  • Countryside, IL
  • NPI 1265487060

  Psychiatry

  NPD (past)
• Premier Behavioral Health Services, P.C.

  • Clinical Psychologist
  • Bensenville, IL
  • NPI 1811168198
  NPD (past)
• Preventative Mental Healthcare Services

  • Clinical Psychologist
  • Downers Grove, IL
  • NPI 1407984131
  NPD (past)
• Synergos P.C.

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1609882422
  NPD (past)

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1861682866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E BROWARD BLVD STE 1700",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013500",
            "telephone_number": "224-269-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E BROWARD BLVD STE 1700",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013500",
            "telephone_number": "224-269-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Revere Dr.",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "60062",
            "country_code": "US",
            "telephone_number": "224-269-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "DAVID",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036117672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861682866",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elise Susan Gates, LMHC
• Sarah Gaumer
• Victoria Macatangay Gaus, M.D.
• Ramila H Gavan, MD
• Gavin Psychiatry, LLC
• Heather Gawad, LMHC
• Debra Gawet
• Olga Gay, CRNA
• Camile S Gayle, LCSW
• Octavio Orona Gaytan, CRNA

• Psychiatry Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.