Active NPI
Steven P Davidson, MD
- Otolaryngology Physician
- Traverse City, MI
National Provider Identifier
1942880661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 4301512043
- Practice address
- 1104 Cass St
Traverse City, MI 49684-3236 - Phone
- (231) 941-1155
- Fax
- (231) 259-1005
- NPI assigned
- Apr 8, 2021
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 4301512043 | MI | Primary |
Addresses
Primary practice location
1104 Cass St
Traverse City, MI 49684-3236
Mailing address
1104 Cass St
Traverse City, MI 49684-3236
Phone (231) 941-1155
Other practice location 1
4201 St Antoine
5E Uhc
Detroit, MI 48201-2153
Phone (269) 718-8619
Other practice location 2
4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260616003780 | MI | Practitioner - Otolaryngology | 1456823897 |
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Wayne State University School of Medicine, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1104 Cass St
Traverse City, MI 49684-3236
1105 6TH St
Traverse City, MI 49684-2386
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- steven.davidson.1@19711.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785888000000",
"number": "1942880661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 CASS ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496843236",
"telephone_number": "231-941-1155",
"fax_number": "231-259-1005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 CASS ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496843236",
"telephone_number": "231-941-1155",
"fax_number": "231-259-1005"
}
],
"practiceLocations": [
{
"address_1": "4201 St Antoine",
"address_2": "5E UHC",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482012153",
"country_code": "US",
"telephone_number": "269-718-8619",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4100 Park Forest Dr",
"address_purpose": "LOCATION",
"city": "Traverse City",
"state": "MI",
"postal_code": "496847331",
"country_code": "US",
"telephone_number": "231-392-8900",
"fax_number": "231-392-8973",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIDSON",
"first_name": "STEVEN",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-08",
"last_updated": "2026-08-05",
"certification_date": "2026-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MI",
"license": "4301512043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.