MR. DOUGLAS IVAN DUSENBERRY (PA-C) – Surgical Physician Assistant, NPI 1790764678

MR. DOUGLAS IVAN DUSENBERRY (PA-C) is a healthcare provider. based in Jbsa ft sam houston, Texas. specializing in Surgical Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA04877 (TX). The NPI Number for MR. DOUGLAS IVAN DUSENBERRY (PA-C) is 1790764678

Main info

Male
Sole Proprietor
Name
MR. DOUGLAS IVAN DUSENBERRY (PA-C)
NPI
1790764678
Phone
(210) 916-5666
Address
3551 ROGER BROOKE DR
Enumeration Date
10 January 2006
Last Update Date
16 August 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MR. DOUGLAS IVAN DUSENBERRY (PA-C)

  • Center for the Intrepid, 3551, Roger Brooke Drive, San Antonio, Bexar County, Texas, 78234, United States

    JBSA FT SAM HOUSTON, TX 782344504

    Phone: (210) 916-5666

    Type: Location

  • 3851 ROGER BROOKE DR

    BROOKE ARMY MEDICAL CENTER

    FORT SAM HOUSTON, TX 782344501

    Phone: (210) 916-0517

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $1,288.

Total Amount is formed as General ($1,288) + Research ($0) + Ownership ($0) = $1,288.

Last reported payment date: 2024-12-28 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($374).

Total Amount

$1,288

General + Research + Ownership

Payments

11

Total payment records

General Amount

$1,288

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-28

Latest reported date

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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: 2023-06-26

PECOS data refreshed: 2026-05-27

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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 78234)

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Reviews

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Frequently asked questions

What number should I use to identify MR. DOUGLAS IVAN DUSENBERRY (PA-C) for billing?
Administrative and clinical systems typically use NPI 1790764678 for MR. DOUGLAS IVAN DUSENBERRY (PA-C).
Is MR. DOUGLAS IVAN DUSENBERRY (PA-C) currently accepting referrals based on NPI status?
Registry metadata lists MR. DOUGLAS IVAN DUSENBERRY (PA-C) as active.
Which specialty label fits MR. DOUGLAS IVAN DUSENBERRY (PA-C)?
NPPES ties MR. DOUGLAS IVAN DUSENBERRY (PA-C) to Surgical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to MR. DOUGLAS IVAN DUSENBERRY (PA-C)?
MR. DOUGLAS IVAN DUSENBERRY (PA-C) shows a connection to Jbsa Ft Sam Houston, Texas in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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