Individual provider Active NPI

Wendy Davis, MD

  • Surgery Physician
  • Las Vegas, NM
National Provider Identifier
1962488288
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD2016-0938 Issued in NM
Practice address
105 Mills Ave Ste 200
Las Vegas, NM 87701-4169
Phone
(505) 426-3795
NPI assigned
Dec 19, 2005
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 042057 GA
Surgery Physician 208600000X MD2016-0938 NM Primary

Addresses

Primary practice location

105 Mills Ave Ste 200
Las Vegas, NM 87701-4169

Mailing address

2101 Central Avenue
Augusta, GA 30904
Phone (706) 738-3359

Other practice location 1

2101 Central Avenue
Augusta, GA 30904
Phone (706) 738-3359

Other identifiers 3

IdentifierTypeStateIssuer
00868612CMedicaidGA
G40257MedicaidSC
000868612BMedicaidGA

Other names 1

  • Miss Wendy Hirschowitz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NM2 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
I20040707000496 GA Practitioner - General Surgery 9638156656
I20170202002400 NM Practitioner - General Surgery 9638156656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Pittsburgh School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

201 Cedar St SE
Suite 306
Albuquerque, NM 87106-4932
Phone (505) 563-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Surgery CurrentSince Feb 18, 2020 Accepting new patients
Presbyterian Healthcare Services CurrentSince Feb 18, 2020 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

201 Cedar St SE
Ste 306
Albuquerque, NM 87106
Phone (505) 247-3635

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: wdavis169463@direct.phs.org
  • Direct secure messaging: wdavis57@yourcarecommunity.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1962488288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CENTRAL AVENUE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30904",
            "telephone_number": "706-738-3359",
            "fax_number": "706-738-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MILLS AVE STE 200",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014169",
            "telephone_number": "505-426-3795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Central Avenue",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "30904",
            "country_code": "US",
            "telephone_number": "706-738-3359",
            "fax_number": "706-738-0565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WENDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "042057",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "MD2016-0938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00868612C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G40257",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000868612B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "HIRSCHOWITZ",
            "prefix": "MISS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NM

Sources for this page

Verify at the official NPI Registry.