MR. DAVID DOUGLAS (P.A.C) – Physician Assistant, NPI 1396760476
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,853 PHYSICIAN ASSISTANT in MO
Provider Addresses for MR. DAVID DOUGLAS (P.A.C)
904 S Pine St
Richland, MO 655567393
Phone: (573) 765-2956
Type: Location
PO BOX 517
MARSHFIELD, MO 657060517
Phone: (417) 849-5072
Type: Mailing
755 COWAN DR
LEBANON, MO 655364629
Phone: (417) 532-2805
Fax: (417) 532-2865
Type: Location
Springfield Post Office, 830-832, Stratford Road, Springfield, Greet, Birmingham, West Midlands, England, B11 4SH, United Kingdom
SPRINGFIELD, MO 658012580
Phone: (417) 829-4620
Type: Mailing
904, South Pine Street, Richland, Pulaski County, Missouri, 65556, United States
RICHLAND, MO 655567393
Phone: (573) 765-2956
Type: Location
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: 2005-02-09
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 |
|---|---|---|---|---|
| I20050209000652 | I | Physician Assistant | MO | 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 |
|---|---|---|---|---|
| 81003 | Automated urinalysis test | 37 | 33 | $0 |
Insurance plans in this area (ZIP 65556)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | MO | 82270 | Stool analysis for blood to screen for colon tumors | 27 | 27 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| Nurse Practitioner | MO | |
| N E U R O L O G Y | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Hematology/Oncology, Internal Medicine | MO | |
| Family Practice | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Family Practice | MO |
Reviews
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