Daniel Ray Douglas, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD18403 Issued in OR

Practice address

9205 SW Barnes Rd
Portland, OR 97225-6603

Phone

(503) 297-6334

Fax

(503) 297-2360

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

95.65 of 100Reported as group

Quality

98.12

Promoting interoperability

100

Improvement activities

40

Cost

80.38

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971

  Emergency Medicine

  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745

  Emergency Medicine

  NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1932295938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 SW BARNES RD",
            "address_2": "SUITE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256623",
            "telephone_number": "503-297-6334",
            "fax_number": "503-297-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-297-6334",
            "fax_number": "503-297-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DANIEL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD18403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "930066657",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057385",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddouglas101480@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9340 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Douglas N Beaman MD PC
• Angela Douglas, MD
• Bruce C Douglas, M.D.
• Cassandra Douglas, LMT
• Chloe Elise Douglas, MD
• David Morrison Douglas, MD
• Edmond Arlen Douglas
• Emelie Angelina Douglas, MA, LPC
• Jae Patricia Douglas, LMSW, PH.D.
• Kaitlyn Douglas, LMT

• Emergency Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.