MR. DAVID W DOUGLAS (MD) – Family Medicine Physician, NPI 1154340420

MR. DAVID W DOUGLAS (MD) is a healthcare provider. based in Lynn, Massachusetts. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 150082 (MA). The NPI Number for MR. DAVID W DOUGLAS (MD) is 1154340420

Main info

Male
Sole Proprietor
32 Years Of Experience
Accepts Medicare Assignment
Name
MR. DAVID W DOUGLAS (MD)
NPI
1154340420
Phone
(781) 593-6005
Address
330 LYNNWAY
Enumeration Date
18 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Secondary Phone
7815936005
Graduation Year
1994 (32 years ago)
PAC ID
5799712782
Group Practice PAC ID
5395011522
Professional Enrollment ID
I20050721000202
Address ID
MA019011713LY330XXLYNN202
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,899 FAMILY PRACTICE in MA

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Provider Addresses for MR. DAVID W DOUGLAS (MD)

  • 330, Lynnway, Lynn, Essex County, Massachusetts, 01901, United States

    SUITE 109A

    LYNN, MA 019011706

    Phone: (781) 593-6005

    Fax: (781) 593-1370

    Mailing address matches the actual address.

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: 2005-07-21

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050721000202IFamily PracticeMATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes259135$0
99213Established patient office or other outpatient visit, 20-29 minutes199108$0
90756Influenza vaccine, quadrivalent derived from cell cultures6666$0
G0008Administration of influenza virus vaccine6666$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit5151$0
View full utilization report →

Insurance plans in this area (ZIP 01901)

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Provider's Procedures

MR. DAVID W DOUGLAS (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMA90670Pneumococcal vaccine for injection into muscle2727

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395011522View full group profile
NameSpecialtyState
Family PracticeMA
-MA
-MA
Plastic And Reconstructive SurgeryMA
Nurse PractitionerMA
Internal Medicine, General PracticeMA
Cardiovascular Disease (Cardiology), Internal MedicineMA
Nurse PractitionerMA
P S Y C H I A T R YMO
Clinical Social WorkerMA

Reviews

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Frequently asked questions

What NPI should I save for MR. DAVID W DOUGLAS (MD)?
Save NPI 1154340420 if you need a stable reference for MR. DAVID W DOUGLAS (MD).
Is MR. DAVID W DOUGLAS (MD) active in the national directory?
MR. DAVID W DOUGLAS (MD)'s public NPI profile is in an active state.
Can you summarize MR. DAVID W DOUGLAS (MD)'s specialty in plain language?
Clinically, the directory lists MR. DAVID W DOUGLAS (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for MR. DAVID W DOUGLAS (MD)?
We surface Lynn, Massachusetts for MR. DAVID W DOUGLAS (MD) based on available NPPES addresses.
How can I contact MR. DAVID W DOUGLAS (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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