DIMITRY SAMUEL DAVYDOW (M.D.) – Psychiatry Physician, NPI 1619911930
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
710 PSYCHIATRY in WA
Provider Addresses for DIMITRY SAMUEL DAVYDOW (M.D.)
PO BOX 50095
SEATTLE, WA 981455095
Phone: (206) 543-6420
Type: Mailing
1959 NE Pacific St
Seattle, WA 981950001
Phone: (206) 598-6195
Type: Location
1600 SW ARCHER RD
GAINESVILLE, FL 326100001
Phone: (352) 265-0301
Type: Location
University of Washington Medical Center - Montlake, 1959, Northeast Pacific Street, University District, Seattle, King County, Washington, 98195, United States
SEATTLE, WA 981950001
Phone: (206) 598-6195
Type: Location
PO BOX 100183
GAINESVILLE, FL 326100183
Phone: (352) 265-4357
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: 2024-01-04
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240104000027 | I | Psychiatry | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98145)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | WA | 90792 | Psychiatric diagnostic evaluation with medical services | 17 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Pain Management | FL | |
| Nurse Practitioner | FL | |
| G A S T R O E N T E R O L O G Y | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| Nurse Practitioner | FL |
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