DR. MICHAEL ROBERT DAVIS (M.D.) – Plastic Surgery Physician, NPI 1477622934

DR. MICHAEL ROBERT DAVIS (M.D.) is a healthcare provider. based in Fort wayne, Indiana. specializing in PLASTIC AND RECONSTRUCTIVE SURGERY. They hold the professional credentials M.D.. They hold a License No. 26620 (AL). The NPI Number for DR. MICHAEL ROBERT DAVIS (M.D.) is 1477622934

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL ROBERT DAVIS (M.D.)
NPI
1477622934
Phone
(260) 479-3514
Address
6920 POINTE INVERNESS WAY STE 200
Enumeration Date
7 November 2006
Last Update Date
19 April 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2102012806
Graduation Year
1998 (28 years ago)
PAC ID
2062510571
Group Practice PAC ID
5890078703
Professional Enrollment ID
I20200709003260
Address ID
TX782293823SA8042XRDXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience70
Completeness75
Years active:19State licenses:3Digital endpointsOther names

126 PLASTIC AND RECONSTRUCTIVE SURGERY in IN

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Provider Addresses for DR. MICHAEL ROBERT DAVIS (M.D.)

  • Pointe Inverness Way, Covington Dells, Fort Wayne, Allen County, Indiana, 46804, United States

    FORT WAYNE, IN 468047934

    Phone: (260) 479-3514

    Fax: (260) 479-3520

    Type: Mailing

  • 306, West Jefferson Boulevard, Fort Wayne, Allen County, Indiana, 46802, United States

    FORT WAYNE, IN 468044128

    Phone: (260) 458-3610

    Fax: (260) 458-3611

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 14 Open Payments records for all available years, with a total value of $1,156.

Total Amount is formed as General ($1,156) + Research ($0) + Ownership ($0) = $1,156.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: TELA Bio, Inc. ($774).

Total Amount

$1,156

General + Research + Ownership

Payments

14

Total payment records

General Amount

$1,156

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2020-07-09

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181210001473IPlastic And Reconstructive SurgeryPATBD
I20200709003260IPlastic And Reconstructive SurgeryTXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99204New patient office or other outpatient visit, 45-59 minutes1313$0
View full utilization report →

Insurance plans in this area (ZIP 46804)

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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: 5890078703View full group profile
NameSpecialtyState
Plastic And Reconstructive SurgeryTX
-TX
Nurse PractitionerFL
Plastic And Reconstructive SurgeryTX
Plastic And Reconstructive SurgeryTX

Reviews

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Frequently asked questions

Can I verify DR. MICHAEL ROBERT DAVIS (M.D.) with an NPI only?
You can start verification with NPI 1477622934 for DR. MICHAEL ROBERT DAVIS (M.D.), then check state licensing separately.
Is DR. MICHAEL ROBERT DAVIS (M.D.) listed as active for patients and plans?
The listing shows DR. MICHAEL ROBERT DAVIS (M.D.) as active in the NPI system.
What healthcare role does DR. MICHAEL ROBERT DAVIS (M.D.) hold?
Scheduling teams often label DR. MICHAEL ROBERT DAVIS (M.D.) under Plastic Surgery Physician. Clinical services aligned with this taxonomy classification.
What area does DR. MICHAEL ROBERT DAVIS (M.D.) serve?
DR. MICHAEL ROBERT DAVIS (M.D.)'s listing highlights Fort Wayne, Indiana; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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