NICHOLAS AUSTIN DAVIS (DO) – Emergency Medicine Physician, NPI 1184183568
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
832 EMERGENCY MEDICINE in OR
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Provider Addresses for NICHOLAS AUSTIN DAVIS (DO)
300 BOULDER FALLS DR APT C209
LEBANON, OR 973552883
Phone: (509) 710-2983
Type: Mailing
College of Osteopathic Medicine of the Pacific-Northwest, 200, Mullins Drive, Lebanon, Linn County, Oregon, 97355, United States
LEBANON, OR 973553983
Phone: (541) 259-0200
Type: Location
750 E ADAMS ST
SYRACUSE, NY 132102306
Phone: (509) 710-2983
Type: Mailing
282 WASHINGTON ST
HARTFORD, CT 061063322
Phone: (860) 545-9000
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: 2025-05-27
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250527001378 | I | Emergency Medicine | CT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97355)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | PA | |
| Nurse Practitioner | CT | |
| Emergency Medicine | OH | |
| Nurse Practitioner | CT | |
| - | CT | |
| - | CT | |
| - | MA | |
| - | CT | |
| Emergency Medicine | CT | |
| Emergency Medicine | MI |
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