NPIMap

Individual provider Active NPI

Xavier Douglas, MD

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1427519982
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
66991 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-3033
Fax
(602) 933-4311
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57.247348 OH
Pediatric Sports Medicine Physician 2080S0010X 66991 AZ
Family Medicine Physician 207Q00000X 66991 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829002570 AZ Practitioner - Family Practice 4486017118 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maricopa County Special Health Care DistrictGroup PAC ID 4688583651, 124 clinicians

Practice addresses (Care Compare)

5650 S 35TH Ave
Phoenix, AZ 85041-3531
Phone (602) 655-6400

Hospital & facility affiliations

  • Valleywise Health Medical Center Hospital, Phoenix, AZ, CCN 030022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57.247348OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Aug 1, 2024 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Maricopa County Special Health Care District Current Accepting new patients
District Medical Group, Inc CurrentSince Aug 1, 2024 Accepting new patients
Phoenix Children'S Hospital Current Accepting new patients
Maricopa County Special Health Care District CurrentSince Jul 22, 2024 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Aug 1, 2023 Accepting new patients
Maricopa County Special Heallth Care District CurrentSince Jul 22, 2024 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Aug 1, 2023 Accepting new patients
The Christ Hospital Medical Associates, LLC Family Medicine PastSince Nov 1, 2008 Accepting new patients
Maricopa County Special Health Care District Past Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

5650 S 35th Ave
Phoenix, AZ 85041
Phone (602) 655-6400

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

33 W Tamarisk St
Phoenix, AZ 85041
Phone (602) 344-6400

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

6990 E Shea Blvd
Ste 104
Scottsdale, AZ 85254

Interoperability endpoints

  • Direct secure messaging: xdouglas271000@direct.valleywisehealth.org
  • Direct secure messaging: xavier.douglas.1@5919.direct.athenahealth.com
  • Direct secure messaging: xavier.douglas.1@15558.direct.athenahealth.com

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 12

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1427519982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-3033",
            "fax_number": "602-933-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "XAVIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "57.247348",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "AZ",
            "license": "66991",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "66991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.