Individual provider Active NPI

Lindsay Alex Davis, PA

  • Physician Assistant
  • Brockton, MA
National Provider Identifier
1861746596
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4564 Issued in MA
Practice address
110 Liberty St
Brockton, MA 02301-5674
Phone
(508) 565-3055
NPI assigned
Nov 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA4564 MA Primary

Addresses

Primary practice location

110 Liberty St
Brockton, MA 02301-5674

Mailing address

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 565-3055

Other practice location 1

277 Pleasant St Ste 101
Fall River, MA 02721-3005
Phone (508) 646-7645

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130307000351 MA Practitioner - Physician Assistant 2567617053 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Hospital & facility affiliations

  • Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Mar 1, 2019 Accepting new patients
Prima Care, PC CurrentSince Apr 1, 2015 Accepting new patients
Prima Care, PC CurrentSince Apr 1, 2015 Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 1, 2019 Accepting new patients

Locations

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

235 Hanover St
Fall River, MA 02720
Phone (508) 646-9525

277 Pleasant St
Ste 101
Fall River, MA 02721
Phone (508) 617-9740

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

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": "1351814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1861746596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-565-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-565-3055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 Pleasant St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027213005",
            "country_code": "US",
            "telephone_number": "508-646-7645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LINDSAY",
        "middle_name": "ALEX",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-02",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.