Ben Harold Douglas II, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

MD19528 Issued in OR

Practice address

1100 3Rd St
Tillamook, OR 97141-3402

Phone

(503) 842-7533

Fax

(503) 842-9636

NPI assigned

Apr 18, 2007

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 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

93.65 of 100Reported as group

Quality

86.8

Promoting interoperability

100

Improvement activities

40

Cost

86.36

Merit-based Incentive Payment System (MIPS)

Final score

83.81 of 100Reported as group

Quality

71.23

Promoting interoperability

88

Improvement activities

40

Cost

81.9

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.

• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Tillamook, OR
  • NPI 1871575225
  Medicare reassignment NPD
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Sheridan, OR
  • NPI 1053873919
  NPD
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Nehalem, OR
  • NPI 1568808285
  NPD

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1952527871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 THIRD ST",
            "address_2": "BAY OCEAN MEDICAL, P.C.",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971418292",
            "telephone_number": "503-842-7533",
            "fax_number": "503-842-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 3RD ST",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413402",
            "telephone_number": "503-842-7533",
            "fax_number": "503-842-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "BEN",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OR",
            "license": "MD19528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952527871",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond Keith Dehaan, O.D.
• Katherine Delleney, M.S.O.M., L.AC.
• Paul Joseph Dennis
• Dentalcare LLC
• Andy Dinh
• Christine J Dowd, MS
• Cecilia Dwigans
• James Eastman, MD
• Jourdan M Ellis, MSW
• Joellyn English

• Adult Medicine Physician in Tillamook, OR
• Providers in Tillamook, OR by specialty
• Adult Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.