MS. MARY KATHRYN DOUGLAS (PAC) – Medical Physician Assistant, NPI 1114928637
Medical Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for MS. MARY KATHRYN DOUGLAS (PAC)
3074 N US 31 S
TRAVERSE CITY, MI 496844533
Phone: (231) 929-1234
Fax: (231) 935-0984
Type: Mailing
5015, North Royal Drive, Garfield Township, Grand Traverse County, Michigan, 49684, United States
TRAVERSE CITY, MI 496849292
Phone: (231) 935-0850
Fax: (231) 935-0869
Type: Mailing
550 Munson Ave
Traverse City, MI 496863580
Phone: (231) 935-8686
Type: Location
1105 Sixth St
Traverse City, MI 496842345
Phone: (231) 935-5000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $367.
Total Amount is formed as General ($367) + Research ($0) + Ownership ($0) = $367.
Last reported payment date: 2024-04-10 • Largest payer in this snapshot: ABBVIE INC. ($181).
Total Amount
$367
General + Research + Ownership
Payments
22
Total payment records
General Amount
$367
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-10
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2014-09-23
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140923002526 | I | Physician Assistant | MI | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 147 | 129 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 74 | 59 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 72 | 57 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 30 | 26 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 28 | 28 | $0 |
Insurance plans in this area (ZIP 49684)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| N E U R O S U R G E R Y | MI | |
| Internal Medicine | IL | |
| Family Practice | MI |
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