Sean T Douglas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA5886 Issued in MA

Practice address

999 Dalton Ave
Pittsfield, MA 01201-2903

Phone

(413) 242-6577

NPI assigned

Sep 13, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, NY2 enrollments

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 2

Specialty

Physician Assistant

Education

State University of New York at Stony Brook, School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Convenientmd - FFS UC LLC 397 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Berkshire Medical Center Hospital, Pittsfield, MA, CCN 220046

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Worcester, MA
  • NPI 1790528628

  MA

  Medicare reassignment Care Compare group
• Berkshire Medical Center, Inc

  • General Acute Care Hospital
  • Pittsfield, MA
  • NPI 1295765261

  MA

  Medicare reassignment NPD
• Berkshire Faculty Services Inc

  • Multi-Specialty Clinic/Center
  • Pittsfield, MA
  • NPI 1548212939

  MA

  Medicare reassignment
• Wellnow Urgent Care, PC

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162

  NY

  Medicare reassignment
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Ellsworth, ME
  • NPI 1780375220
  Care Compare group
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Nashua, NH
  • NPI 1851082291
  Care Compare group
• Berkshire Medical Center Inc.

  • Community/Retail Pharmacy
  • North Adams, MA
  • NPI 1932649753
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Hudson, MA
  • NPI 1265227441
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sturbridge, MA
  • NPI 1386526192
  NPD
• Fairview Hospital

  • Rural Health Clinic/Center
  • Great Barrington, MA
  • NPI 1881252286
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Pittsfield, MA
  • NPI 1568153930
  NPD (past)
• Convenientmd LLC

  • Urgent Care Clinic/Center
  • Newburyport, MA
  • NPI 1316428824
  NPD (past)

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

• Berkshire Medical Center, Inc

  • General Acute Care Hospital
  • Pittsfield, MA
  • NPI 1295765261

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1689122129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 DALTON AVE",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012012903",
            "telephone_number": "413-242-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SEAN",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-13",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019994-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith M Dorr, AA
• Kevin Paul Doscher, PSYD
• Susan Doscher, LICSW
• Jeffrey B Doshier, M.D.
• Julie Ann Dostie, LICSW
• Thomas L. Dourmashkin, M.D.
• Linda Dowd
• Susan F Downey Luhrmann, A.N.P.
• Downtown Physical Therapy LLC
• Daniel M Doyle, MD

• All providers in Pittsfield, MA
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.