WAYNE ALBERT DAVIS (D.O.) – Family Medicine Physician, NPI 1063610293

WAYNE ALBERT DAVIS (D.O.) is a healthcare provider. based in Phoenix, Arizona. specializing in FAMILY PRACTICE. They hold the professional credentials D.O.. They hold a License No. 4825 (AZ). The NPI Number for WAYNE ALBERT DAVIS (D.O.) is 1063610293

Main info

Male
20 Years Of Experience
Accepts Medicare Assignment
Name
WAYNE ALBERT DAVIS (D.O.)
NPI
1063610293
Phone
(480) 882-4545
Address
4131 N 24TH ST STE B102
Enumeration Date
10 July 2007
Last Update Date
29 September 2025

Doctor Profile

Medical School Name
ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Secondary Phone
4808824545
Graduation Year
2006 (20 years ago)
PAC ID
9830225499
Group Practice PAC ID
3577743764
Professional Enrollment ID
I20100407000514
Address ID
AZ850166231PH4131XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness85
Years active:18State licenses:1Digital endpointsOther names

2,260 FAMILY PRACTICE in AZ

Provider Addresses for WAYNE ALBERT DAVIS (D.O.)

  • 4131 N 24TH ST STE B102

    PHOENIX, AZ 850166231

    Phone: (480) 882-4545

    Fax: (602) 903-7091

    Type: Location

  • East Van Buren Street, Phoenix, Maricopa County, Arizona, 85257-1102, United States

    PHOENIX, AZ 850086920

    Phone: (602) 243-7277

    Fax: (602) 286-0808

    Type: Mailing

  • 7500 N DREAMY DRAW DR STE 145

    PHOENIX, AZ 850204668

    Phone: (480) 882-4545

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-04-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100407000514IFamily PracticeAZTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 85016)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577743764View full group profile

Reviews

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Frequently asked questions

What is WAYNE ALBERT DAVIS (D.O.)'s NPI number?
WAYNE ALBERT DAVIS (D.O.)'s NPI is 1063610293 — the number used across U.S. healthcare to identify this provider.
Would WAYNE ALBERT DAVIS (D.O.) appear as active to a payer?
You can treat WAYNE ALBERT DAVIS (D.O.) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is WAYNE ALBERT DAVIS (D.O.)?
WAYNE ALBERT DAVIS (D.O.) is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is WAYNE ALBERT DAVIS (D.O.) associated with Phoenix?
Public fields place WAYNE ALBERT DAVIS (D.O.) around Phoenix, Arizona. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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