PATRICK DAVIS PA-C LTD
NPI 1366702797
Physician Assistant - Surgical in Boulder City, NV
About Patrick Davis Pa-c Ltd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PATRICK DAVIS PA-C LTD (NPI 1366702797) is a healthcare organization registered as a surgical in Boulder City, Nevada and active in the NPI registry since May 2012. The organization lists Patrick Davis, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and revalidation status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Patrick Davis Pa-c Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Patrick Davis Pa-C Ltd's NPI number?
The NPI number for Patrick Davis Pa-C Ltd is 1366702797. It was assigned to this organization in the NPPES registry on May 18, 2012.
Where is Patrick Davis Pa-C Ltd located?
Patrick Davis Pa-C Ltd is located at 724 Kendall Ln, Boulder City, NV 89005. The listed phone number is (702) 604-7422.
What is Patrick Davis Pa-C Ltd's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Patrick Davis Pa-C Ltd enrolled in Medicare?
Yes. Patrick Davis Pa-C Ltd is registered in the Medicare PECOS enrollment system.
When is Patrick Davis Pa-C Ltd's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Nevada, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
When was this NPI record last updated?
The NPPES record for Patrick Davis Pa-C Ltd was last updated on October 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.
# Patrick Davis Pa-C Ltd · NPI 1366702797
Surgical organization in Boulder City, Nevada. Organization record, active in the CMS NPPES registry since May 18, 2012.
## Identity
- **NPI:** 1366702797 (Entity type: Organization)
- **Enumerated:** May 18, 2012
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **Organization subpart:** No
- **Authorized official:** Patrick Davis, OWNER
## Practice location
- **Address:** 724 KENDALL LN, Boulder City, NV 89005-1112
- **Phone:** (702) 604-7422 · **Fax:** (908) 345-8788
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Nevada, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
## Record status
- **NPPES last updated:** October 22, 2019
- **Other identifiers:** Other NV20091190921 (NV)
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Source: [NPI Profile](https://npiprofile.com/npi/1366702797) · Data from the CMS NPPES public registry.