Douglas William Reavie, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

G47917 Issued in CA

Practice address

15717 Bernardo Heights Pkwy
San Diego, CA 92128-3155

Phone

(858) 451-1908

Fax

(858) 451-0423

NPI assigned

Feb 26, 2007

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1720114291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15717 BERNARDO HEIGHTS PKWY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283155",
            "telephone_number": "858-451-1908",
            "fax_number": "858-451-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15717 BERNARDO HEIGHTS PKWY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283155",
            "telephone_number": "858-451-1908",
            "fax_number": "858-451-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVIE",
        "first_name": "DOUGLAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G47917",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "G47917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Reasbeck, M.F.T.
• Sherry Reasbeck
• Richard Reason
• Vitou Reat
• Elika NE'Sheal Reaux
• James Alton Reavis Jr., PSYD
• Karen Reavis, N.P.
• Reaware Licensed Clinical Social Work Prof Corp
• Reaware Outreach, Inc.
• Rebecca a. Marsh, DDS, Apc

• Plastic Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.