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TAMARA DAVYDOVA FNP-BC, WCC, OMS
NPI 1093506958
Nurse Practitioner - Family in Flushing, NY

Active since May 13, 2025PECOS Enrolled
14404 69TH RD, FLUSHING, NY 11367(347) 656-3730 Get Directions Write a Review

NPPES record last updated: June 10, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 10, 2025, May 13, 2025 (2 updates tracked since 2025).

About Tamara Davydova Fnp-bc, Wcc, Oms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAMARA DAVYDOVA FNP-BC, WCC, OMS (NPI 1093506958) is an individual family provider in Flushing, New York, licensed in New York (F355879-07) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1093506958
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTAMARA DAVYDOVACredential: FNP-BC, WCC, OMS
Location Address14404 69TH RDFlushing, NY 11367-1702
Mailing Address14404 69th RdFlushing, NY 11367-1702 · (347) 656-3730
Phone(347) 656-3730
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMay 13, 2025
Last NPPES UpdateJune 10, 20252 updates tracked since enumeration
NPPES CertifiedJune 10, 2025
✔ NPI 1093506958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · F355879-07
Also ListedRegistered Nurse · Wound CareTaxonomy 163WW0000X · License 620695 (NY)
Also ListedRegistered Nurse · Ostomy CareTaxonomy 163WX1500X · License 620695 (NY)
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License F355879-07 (NY)
14404 69TH RD, Flushing, NY 11367
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tamara Davydova Fnp-bc, Wcc, Oms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5890289896
PECOS Enrollment IDI20251208002539
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Tamara Davydova reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ultrasonics Diagnostics LLC
3.4 mi
Physiological Laboratory
7309 MYRTLE AVE
Glendale, NY 11385
  • Reassigned Medicare billing, New York enrollment
  • 6 clinicians in this Medicare group
NPI 1215391883 (718) 497-1429

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11367 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.17 typical visit price
range $67.00 – $201.98
Typical copayment $26.04 (range $16.75 – $50.49)
Most-billed visit code 99203
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tamara Davydova's NPI number?

The NPI number for Tamara Davydova is 1093506958. It was assigned to this individual provider in the NPPES registry on May 13, 2025.

Where is Tamara Davydova located?

Tamara Davydova practices at 14404 69th Rd, Flushing, NY 11367. The listed phone number is (347) 656-3730.

What is Tamara Davydova's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Tamara Davydova enrolled in Medicare?

Yes. Tamara Davydova is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tamara Davydova's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tamara Davydova reassigns Medicare benefits to Ultrasonics Diagnostics LLC (Glendale, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tamara Davydova's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tamara Davydova was last updated on June 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.