Individual provider Active NPI

Daniel Douglas, PA-C

  • Physician Assistant
  • Fort Carson, CO
National Provider Identifier
1073168571
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
Evans Army Community Hospital
650 Cochrane Circle
Fort Carson, CO 80913-4604
Phone
(719) 526-2361
NPI assigned
Aug 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

Evans Army Community Hospital
650 Cochrane Circle
Fort Carson, CO 80913-4604

Mailing address

Evans Army Community Hospital
650 Cochrane Circle
Fort Carson, CO 80913-4604
Phone (719) 526-2361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127000982 IA Practitioner - Physician Assistant 5597113936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

1055 SW Oralabor Rd
Upc Express Care
Ankeny, IA 50023-1280
Phone (515) 965-7661

2103 Ingersoll Ave
Des Moines, IA 50312-5227

2720 8TH St SW
Altoona, IA 50009-1028
Phone (515) 967-0133

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

4480 Utica Ridge Rd
Suite 160
Bettendorf, IA 52722-1637
Phone (563) 742-5950

5200 100TH St
Urbandale, IA 50322-7208
Phone (515) 251-3880

6520 SE 14TH St
Des Moines, IA 50320-1846
Phone (515) 953-1500

Hospital & facility affiliations

  • Unitypoint Health - Des Moines Iowa Methodist Medi Hospital, Des Moines, IA, CCN 160082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Oct 23, 2023 Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Oct 23, 2023 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

2720 8th St SW
Ste A2
Altoona, IA 50009
Phone (515) 967-0133

3625 N Ankeny Blvd
Ste E
Ankeny, IA 50023
Phone (515) 965-4664

1055 SW Oralabor Rd
Ankeny, IA 50023
Phone (515) 371-9406

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

2103 Ingersoll Ave
Ste 2
Des Moines, IA 50312
Phone (515) 323-5680

6520 SE 14th St
Des Moines, IA 50320
Phone (515) 256-4242

5200 100th St
Urbandale, IA 50322
Phone (515) 265-4211

950 E Hickman Rd
Waukee, IA 50263
Phone (515) 987-8256

6000 University Ave
Ste 101
West Des Moines, IA 50266
Phone (515) 241-2320

180 Jordan Creek Pkwy
Ste 120
West Des Moines, IA 50266
Phone (515) 224-5868

Interoperability endpoints

  • Direct secure messaging: ddouglas981178@direct.unitypoint.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1073168571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EVANS ARMY COMMUNITY HOSPITAL",
            "address_2": "650 COCHRANE CIRCLE",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EVANS ARMY COMMUNITY HOSPITAL",
            "address_2": "650 COCHRANE CIRCLE",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-02",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.