BRANDON DOUGLASS – Physician Assistant, NPI 1639626609

BRANDON DOUGLASS is a healthcare provider. based in Hillsdale, Michigan. specializing in PHYSICIAN ASSISTANT. The NPI Number for BRANDON DOUGLASS is 1639626609

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
BRANDON DOUGLASS
NPI
1639626609
Phone
Not provided
Address
3271 W CARLETON RD
Enumeration Date
7 September 2016
Last Update Date
7 September 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5174377040
Graduation Year
2016 (10 years ago)
PAC ID
7911294749
Group Practice PAC ID
7214846260
Professional Enrollment ID
I20160922001221
Address ID
MI492425034HI240XXRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:9State licenses:0Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

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Provider Addresses for BRANDON DOUGLASS

  • West Carleton Road, Hillsdale, Fayette Township, Hillsdale County, Michigan, 49242, United States

    HILLSDALE, MI 492429458

    Phone:

    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)

CMS reports 293 Open Payments records for all available years, with a total value of $4,851.

Total Amount is formed as General ($4,851) + Research ($0) + Ownership ($0) = $4,851.

Last reported payment date: 2024-12-26 • Largest payer in this snapshot: Novo Nordisk Inc ($813).

Total Amount

$4,851

General + Research + Ownership

Payments

293

Total payment records

General Amount

$4,851

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-26

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2016-09-22

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
I20160922001221IPhysician AssistantMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49242)

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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: 7214846260View full group profile
NameSpecialtyState
Physician AssistantMI
O B S T E T R I C S/ G Y N E C O L O G YOH
Nurse PractitionerMI
-MI
Nurse PractitionerMI
-MI
Nurse PractitionerMI
Diagnostic RadiologyFL
Nurse PractitionerMI
O B S T E T R I C S/ G Y N E C O L O G YMI

Reviews

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Frequently asked questions

How do I look up BRANDON DOUGLASS by NPI?
Use NPI 1639626609 when you need to reference BRANDON DOUGLASS in forms, claims, or directories.
Is BRANDON DOUGLASS's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize BRANDON DOUGLASS's specialty in plain language?
Clinically, the directory lists BRANDON DOUGLASS with Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for BRANDON DOUGLASS?
The page summarizes Hillsdale, Michigan for BRANDON DOUGLASS; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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