JASON DOUGLAS (PA-C) – Physician Assistant, NPI 1457606618
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
1,854 PHYSICIAN ASSISTANT in MO
Provider Addresses for JASON DOUGLAS (PA-C)
304 S Mount Auburn Rd
Cape Girardeau, MO 637034920
Phone: (573) 651-1687
Type: Location
901 E 104TH ST
KANSAS CITY, MO 641314517
Phone: (816) 502-8752
Fax: (816) 932-9670
Type: Mailing
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO 637034920
Phone: (573) 651-1687
Type: Location
2861 NE INDEPENDENCE AVE
STE 201
LEES SUMMIT, MO 640642379
Phone: (816) 502-8752
Fax: (816) 932-9670
Type: Mailing
23401 PRAIRIE STAR PKWY STE B-300
LENEXA, KS 662277268
Phone: (913) 677-6319
Fax: (913) 677-1450
Type: Mailing
2101 Corona Rd Ste 102
Columbia, MO 652032582
Phone: (573) 234-1800
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: 2021-01-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20121008000643 | I | Physician Assistant | MO | TBD |
| I20210111002204 | I | Physician Assistant | KS | 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 |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 899 | 178 | $0 |
Insurance plans in this area (ZIP 63703)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| General Surgery | KS | |
| Physical Therapist In Private Practice | KS | |
| Nurse Practitioner | MO | |
| Clinical Psychologist | KS | |
| - | CO | |
| General Surgery | KS | |
| Physical Therapist In Private Practice | MO | |
| Clinical Psychologist | KS | |
| General Surgery | MO |
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