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Active NPI 1477622934 Individual Practitioner Male Practitioner

Dr. Michael Robert Davis , MD

Plastic Surgery • Fort Wayne, IN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michael Davis, MD is a certified Plastic Surgery practicing in Fort Wayne, IN. With approximately 28 years of clinical experience since completing medical education in 1998, Dr. Davis delivers high-quality medical care to the local community at 7900 W JEFFERSON BLVD STE 306.

Dr. Davis is affiliated with South Texas Aesthetic And Reconstructive Surgery Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

7900 W Jefferson Blvd Ste 306

Fort Wayne, IN 468044128

Telephone 2604583610
Fax 2604583611

Medicare Profile & Education

Medical School

Other

Graduation Year

1998

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Fort Wayne, IN

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
28 Yrs -2.6 yrs vs City Avg
City Avg: 30.6 Yrs
State Avg: 25.7 Yrs
Regional Practice Density
11 Specialists

Practicing in Fort Wayne, IN (84 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
75.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Davis (28 Years) 28 Yrs
Fort Wayne Specialty Average (30.6 Years) 30.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
13 13 $643.08 $159.85

Medical Specialties & State Licenses

Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

State License IN 01053296A

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Plastic Surgery

NUCC Taxonomy Code: 208200000X

State License AL 26620

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Plastic Surgery

NUCC Taxonomy Code: 208200000X

State License TX P1857

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
009941892 (AL)
Medicaid State Provider ID
009941891 (AL)
Medicaid State Provider ID
009942208 (AL)
Commercial Insurance / Payer ID Bcbs
051540216 (AL)
Commercial Insurance / Payer ID Bcbs
051540217 (AL)
Commercial Insurance / Payer ID Bcbs
051540215 (AL)

Hospital & Practice Group Affiliations

South Texas Aesthetic And Reconstructive Surgery Pllc

8042 Wurzbach Rd, San Antonio, TX 782293823

Phone: 2102012806

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

18 Associated Practitioners
Victoria Vamos , PA-C

Physician Assistant

NPI 1083311435

Physician Assistant (Certified)

Geoffrey Mccord , NP

Nurse Practitioner - Family

NPI 1124302633

Nurse Practitioner

Karsten Cooper , PA-C

Physician Assistant

NPI 1124698311

Physician Assistant (Certified)

Milissa Phillips-Bohlender , NP

Nurse Practitioner - Family

NPI 1164474045

Nurse Practitioner

Dr. Keith Clancy , MD

Surgery - Trauma Surgery

NPI 1164482303

Doctor of Medicine (M.D.)

Dr. Tianli Du , MD

Surgery - Trauma Surgery

NPI 1205217148

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location April 19, 2018

Registered at 7900 W JEFFERSON BLVD STE 306, FORT WAYNE, IN 468044128 (Tel: 2604583610)

📍
Updated Business Mailing Address April 19, 2018

Registered at 6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 468047934 (Tel: 2604793514)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 19, 2018

Plastic Surgery (License #01053296A in IN)

NPI Profile Active September 24, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location September 24, 2012

Registered at 2632 BROADWAY ST, SUITE 201, SAN ANTONIO, TX 782151137 (Tel: 2058211876)

📍
Updated Business Mailing Address September 24, 2012

Registered at 215 N CENTER, #1906, SAN ANTONIO, TX 782022717 (Tel: 2058211876)

👤
Provider Name / Credentials Updated September 24, 2012

Recorded as MICHAEL DAVIS, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 24, 2012

Plastic Surgery (License #P1857 in TX)

🟢
Initial NPI Registration & Enumeration November 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477622934
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 07, 2006
Last Update: April 19, 2018
Sole Proprietor: No

Mailing Address

6920 Pointe Inverness Way Ste 200

Fort Wayne, IN 468047934

Phone: 2604793514

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.