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DR. PHILIP A DAVIDSON MEDICAL DOCTOR
NPI 1528040367
Orthopaedic Surgery - Sports Medicine in Park City, UT

Active since November 17, 2005Opted out of Medicare · through Apr 1, 2027
2200 PARK AVE BLDG D, STE 100, PARK CITY, UT 84060(435) 615-8822(435) 615-8823 Get Directions Write a Review

NPPES record last updated: October 1, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Philip A Davidson Medical Doctor NPPES

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

DR. PHILIP A DAVIDSON MEDICAL DOCTOR (NPI 1528040367) is an individual sports medicine provider in Park City, Utah, licensed in Florida (ME54865) and active in the NPI registry since November 2005. He has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1528040367
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameDR. PHILIP A DAVIDSONCredential: MEDICAL DOCTOR
Location Address2200 PARK AVE BLDG D, STE 100Park City, UT 84060-7246
Mailing Address2200 Park Ave Bldg D, Ste 100Park City, UT 84060-7246 · (435) 615-8822 · Fax (435) 615-8823
Phone(435) 615-8822
Fax(435) 615-8823
Sole ProprietorNo
Enumeration DateNovember 17, 2005
Last NPPES UpdateOctober 1, 2012
✔ NPI 1528040367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in FL · ME54865
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
2200 PARK AVE BLDG D, Park City, UT 84060
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Other Identifiers 7

Medicare PIN18987ZFL
Other2000016351FL · Railroad Medicare
Medicare UPINF20200FL
Medicaid373524900FL
Other4511587FL · Aetna
OtherAVMEDFL · 258113
Other18987FL · Blue Cross Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Dr. Philip A Davidson Medical Doctor has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2015 through April 1, 2027.

Opt-Out Effective DateApril 1, 2015
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KAREN D. HEIDEN MD
Orthopaedic Surgery (Hand Surgery)
2200 PARK AVE BLDG D, STE 100
PARK CITY, UT 84060
Summit County (435) 615-8822
DR. ERIC A HEIDEN MD
Orthopaedic Surgery (Sports Medicine)
2200 PARK AVE BLDG D
PARK CITY, UT 84060
Summit County (435) 615-8822

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 Philip Davidson's NPI number?

The NPI number for Philip Davidson is 1528040367. It was assigned to this individual provider in the NPPES registry on November 17, 2005.

Where is Philip Davidson located?

Philip Davidson practices at 2200 Park Ave Bldg D Ste 100, Park City, UT 84060. The listed phone number is (435) 615-8822.

What is Philip Davidson's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Philip Davidson enrolled in Medicare?

No. Philip Davidson has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Philip Davidson accept?

Health plans from Select Health list Philip Davidson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Philip Davidson was last updated on October 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.