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Individual provider Active NPI

Samuel Davidoff, MD

  • Gastroenterology Physician
  • Forest Hills, NY
National Provider Identifier
1922055276
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
229243 Issued in NY
Practice address
10816 72ND Ave
2 Floor
Forest Hills, NY 11375-5350
Phone
(718) 261-0900
Fax
(718) 261-0944
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 229243 NY Primary

Addresses

Primary practice location

10816 72ND Ave
2 Floor
Forest Hills, NY 11375-5350

Mailing address

10816 72ND Ave
2 Floor
Forest Hills, NY 11375-5350
Phone (718) 261-0900

Other identifiers 2

IdentifierTypeStateIssuer
1427214949OtherNYGASTROENTEROLOGY
0299382MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510000487 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 5395734917 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
State University of New York at Stony Brook, School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastroenterology and Nutrition PCGroup PAC ID 2567530736, 3 clinicians

Practice addresses (Care Compare)

10816 72ND Ave
Suite 2
Forest Hills, NY 11375-5656
Phone (718) 261-0900

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
25.91 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
86.35

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy123
Upper gastrointestinal (GI) endoscopy for acid reflux92

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Works Medical PC Gastroenterology CurrentSince Aug 15, 2025 Accepting new patients
Male and Female Urology PLLC Past Accepting new patients
Safe Anesthesia PLLC PastSince Aug 1, 2008 Accepting new patients
Queens Long Island Medical Group, P.C. Past Accepting new patients

Locations

10816 72nd Ave
Ste 3
Forest Hills, NY 11375
Phone (718) 261-0900

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: sdavidoff@1538.mdlanddirect.com

Organizations & group practices 5

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 7

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1922055276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10816 72ND AVE",
            "address_2": "2 FLOOR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755350",
            "telephone_number": "718-261-0900",
            "fax_number": "718-261-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10816 72ND AVE",
            "address_2": "2 FLOOR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755350",
            "telephone_number": "718-261-0900",
            "fax_number": "718-261-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOFF",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "229243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GASTROENTEROLOGY",
            "identifier": "1427214949",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0299382",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.