Active NPI
Glenn Davis, MD
- Internal Medicine Physician
- Mount Vernon, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 149868
- Practice address
- 107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550 - Phone
- (914) 699-7200
- Fax
- (914) 699-0837
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 149868 | NY | Primary |
Addresses
Primary practice location
107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Mailing address
107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Phone (919) 699-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0118965 | Medicaid | NY |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Meharry Medical College School of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
107 W 4TH St
Mount Vernon, NY 10550-4002
Phone 9146997200660
Hospital & facility affiliations
- White Plains Hospital Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Vernon Neighborhood Health Center Inc | Current | Accepting new patients | |
| Mount Vernon Neighborhood Health Center, Inc. | Current | Accepting new patients | |
| Valiere Alcena MD PC | Internal Medicine | Past | Accepting new patients |
| Mount Vernon Neighborhood Health Center, Inc. | Past | Accepting new patients | |
| Resource Anesthesiology Associates,PC | Past | Accepting new patients |
Locations
107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235
295 Knollwood Rd
White Plains, NY 10607
Phone (914) 699-7200
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482
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.
-
- Specialist
- Mount Vernon, NY
- NPI 1295912541
-
- Federally Qualified Health Center (FQHC)
- Yonkers, NY
- NPI 1952550055
-
- Federally Qualified Health Center (FQHC)
- Mount Vernon, NY
- NPI 1396736120
-
- Anesthesiology Physician
- Harrison, NY
- NPI 1588647200
-
- Hematology & Oncology Physician
- White Plains, NY
- NPI 1700829009
Internal Medicine
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- White Plains, NY
- NPI 1447255153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321488000000",
"number": "1932277654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 WEST 4TH STREET",
"address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "10550",
"telephone_number": "919-699-7200",
"fax_number": "914-699-0837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 WEST 4TH STREET",
"address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "10550",
"telephone_number": "914-699-7200",
"fax_number": "914-699-0837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "GLENN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2011-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "149868",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0118965",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.