DOUGLAS PETER DAVIDSON JR. PA
NPI 1174294938
Physician Assistant in San Rafael, CA

NPI Status: Active since September 22, 2021

Contact Information

50 ACACIA AVE
SAN RAFAEL, CA
ZIP 94901
Phone: (951) 816-8970

Get Directions Reviews

  • Individual
  • Male
  • Years of Experience 4
  • Physician Assistant
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DOUGLAS DAVIDSON

This page provides the complete NPI Profile along with additional information for Douglas Davidson, a primary care provider established in San Rafael, California with a medical specialization in Physician Assistant and more than 4 years of experience. The healthcare provider is registered in the NPI registry with number 1174294938 assigned on September 2021. The practitioner's primary taxonomy code is 363A00000X with license number 62399 (CA). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1174294938
Provider Name
DOUGLAS PETER DAVIDSON JR. PA
Gender
Male
Entity Type
Individual
Location Address
50 ACACIA AVE SAN RAFAEL, CA 94901
Location Phone
(951) 816-8970
Mailing Address
38332 MAPLE CT MURRIETA, CA 92562
Mailing Phone
(951) 816-8970
Medical School Name
OTHER
Graduation Year
2022
Is Sole Proprietor?
No
Enumeration Date
09-22-2021
Last Update Date
03-07-2023
Code Navigator

A primary care provider (PCP) like Douglas Davidson sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
62399
License State
CA
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Medicare Participation & PECOS Enrollment Status

Douglas Davidson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Douglas Davidson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 9830563956

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20230313000971

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $26.16 for a new patient copayment and $21.25 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 94901 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $104.67
  • Minimum New Patient Price $69.07
  • Maximum New Patient Price $202.63
  • Average New Patient Copayment $26.16
  • Minimum New Patient Copayment $17.26
  • Maximum New Patient Copayment $50.65

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $85
  • Minimum Established Patient Price $23.44
  • Maximum Established Patient Price $166.64
  • Average Established Patient Copayment $21.25
  • Minimum Established Patient Copayment $5.86
  • Maximum Established Patient Copayment $41.66

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for DOUGLAS PETER DAVIDSON JR. PA

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1174294938
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2114449896
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 4 + 4 + 4 + 9 + 8 + 9 + 6 + 24 = 72
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 72 = 88

The NPI number 1174294938 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1417921339MR. JESSE J MAZZA A.T.,C.
Individual
Specialist50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 257-1353
1487114534 TORSTEN HALL DURKAN
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1639632847 EVELYN JOAN FAHEY
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(203) 470-6074
1780228882 MONA ALIKHANI SERESHT PA-S
Individual
Student in an Organized Health Care Education/Training Program50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 547-4440
1598309692 DALIA SHARONA AZIZI PA STUDENT
Individual
Student in an Organized Health Care Education/Training Program50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-9490
1134763246 SARAH ABOUELJOUD
Individual
Student in an Organized Health Care Education/Training Program50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1659833291 JULIE BLANCHARD
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(617) 877-3508
1013321264 MIGUEL SERRATO ATC OT-C
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1487269346 TATYANA KOVALEVSKIJ
Individual
Student in an Organized Health Care Education/Training Program50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1093329989 EMILY GAO
Individual
Student in an Organized Health Care Education/Training Program50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1407490501 CYNTHIA GALVEZ
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1356012157 COURTNEY USELTON
Individual
Physician Assistant (Medical)50 ACACIA AVE
SAN RAFAEL, CA 94901
(616) 633-9988
1548931348 MARINA SOPHIA PAPPAS
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1710658505 JENNIFFER GIELYN ANDES
Individual
Student in an Organized Health Care Education/Training Program50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 533-0121
1720693682 CHANTAL ELIZAGA
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1770127870 JENNIFER LAU PA
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1922568856 AUDREY ELIZABETH SCHNEIDER-HAWES PA-S
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 482-3571
1992368419 HUONG LE BUI
Individual
Physician Assistant50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1659093987 LISA M. CHEUNG
Individual
Student in an Organized Health Care Education/Training Program50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440
1801516380 NATALI FEYZBAKHSH
Individual
Student in an Organized Health Care Education/Training Program50 ACACIA AVE
SAN RAFAEL, CA 94901
(415) 457-4440

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174294938, enumerated in the NPI registry as an "individual" on September 22, 2021

The provider is located at 50 Acacia Ave San Rafael, Ca 94901 and the phone number is (951) 816-8970

The provider's speciality is Physician Assistant with taxonomy code 363A00000X

The provider has more than 4 years of experience.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $104.67 with an average copayment of $26.16 for new patient appointments. Established patients should expect a typical charge of $85 and an average copayment of 21.25. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on September 22, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.