DR. JACK B DAVIDOFF (MD) – Family Medicine Physician, NPI 1972519932
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. JACK B DAVIDOFF (MD)
117 PALM PL
HAINES CITY, FL 338445813
Phone:
Type: Mailing
1600 LAKELAND HILLS BLVD
LAKELAND, FL 338053065
Phone: (863) 680-7000
Fax: (866) 264-8519
Type: Mailing
2300 E COUNTY ROAD 540A
LAKELAND, FL 338133825
Phone: (863) 680-7190
Fax: (866) 264-8519
Type: Location
Interlake Oncology, 156, West Avenue, Brockport, Clarkson, Monroe, New York, 14420, United States
BUSINESS OFFICE
BROCKPORT, NY 144201229
Phone: (585) 395-6095
Fax: (585) 395-6039
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: 2015-12-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040331001254 | I | Emergency Medicine | NY | TBD |
| I20151207002797 | I | Family Practice | FL | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1071 | Injection, testosterone cypionate, 1 mg | 17,745 | 21 | $0 |
| J0897 | Injection, denosumab, 1 mg | 7,620 | 127 | $0 |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | 2,950 | 26 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 477 | 200 | $0 |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis, each additional hour | 186 | 12 | $0 |
Insurance plans in this area (ZIP 33844)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NY | |
| Nurse Practitioner | NY | |
| Emergency Medicine | NY | |
| - | NY | |
| Family Practice | NY | |
| - | VA | |
| Emergency Medicine | NY | |
| Emergency Medicine | NY | |
| Emergency Medicine | NY | |
| - | NY |
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