Individual provider Active NPI

Trevor E Davis, MD

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1932361292
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
253046 Issued in MA
Practice address
800 Washington St
Box 190
Boston, MA 02111-1552
Phone
(617) 636-5071
Fax
(617) 636-8388
NPI assigned
Jun 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X MD20462 RI
Student in an Organized Health Care Education/Training Program 390200000X 62474 NY
Pediatric Rheumatology Physician 2080P0216X 253046 MA
Pediatrics Physician 208000000X 253046 MA Primary

Addresses

Primary practice location

800 Washington St
Box 190
Boston, MA 02111-1552

Mailing address

800 Washington St
Box 190
Boston, MA 02111-1552
Phone (617) 636-5071

Other practice location 1

200 Libbey Owens Parkway
Weymouth, MA 02189
Phone (781) 216-3800

Other practice location 2

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120928000544 MA Practitioner - Pediatric MedicinePractitioner - Rheumatology 9436308855 Reassigns benefits to 2 organizations
I20250305000911 RI Practitioner - RheumatologyPractitioner - Pediatric Medicine 9436308855 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD20462RIMDPediatric Rheumatology Physician
62474NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Pediatrics CurrentSince Feb 26, 2025 Accepting new patients
Pratt Pediatric Associates Inc Pediatrics CurrentSince Jul 10, 2012 Accepting new patients
Rhode Island Hospital CurrentSince Feb 26, 2025 Accepting new patients
Children'S Hospital Pediatric Associates, Inc Pediatrics CurrentSince Jul 9, 2024 Accepting new patients

Locations

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

800 Washington St
#190
Boston, MA 02111
Phone (617) 636-5071

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

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

200 Libbey Park
Weymouth, MA 02189
Phone (781) 216-0160

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

593 Eddy St
Lowr
Providence, RI 02903
Phone (401) 444-4471

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

Interoperability endpoints

  • Direct secure messaging: tdavis29104@tuftsmedicine.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1932361292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "BOX 190",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5071",
            "fax_number": "617-636-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "BOX 190",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5071",
            "fax_number": "617-636-8388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Libbey Owens Parkway",
            "address_purpose": "LOCATION",
            "city": "Weymouth",
            "state": "MA",
            "postal_code": "02189",
            "country_code": "US",
            "telephone_number": "781-216-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TREVOR",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "RI",
            "license": "MD20462",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "62474",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "MA",
            "license": "253046",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "253046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.