Douglas Peter Davidson Jr, PA - Medicare Physician Assistant in San Rafael, CA

  1. Home
  2. Physician Assistant
  3. CA
  4. San Rafael
Douglas Peter Davidson Jr, PA is a medicare enrolled "Physician Assistant" in San Rafael, California. He graduated from nursing school in 2022 and has 4 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Clinic Services Of California Medical Group Inc, Dignity Health Medical Foundation and his current practice location is 50 Acacia Ave, San Rafael, California. You can reach out to his office (for appointments etc.) via phone at (951) 816-8970.

Douglas Peter Davidson Jr is licensed to practice in California (license number 62399) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1174294938.

Contact Information

Douglas Peter Davidson Jr, PA
50 Acacia Ave,
San Rafael, CA 94901-2230
(951) 816-8970
Not Available

Map and Direction




Provider's Profile

Full NameDouglas Peter Davidson Jr
GenderMale
SpecialityPhysician Assistant
Experience4 Years
Location50 Acacia Ave, San Rafael, California
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Douglas Peter Davidson Jr graduated from nursing school in 2022
  NPI Data:
  • NPI Number: 1174294938
  • Provider Enumeration Date: 09/22/2021
  • Last Update Date: 03/07/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9830563956
  • Enrollment ID: I20230313000971

Medical Identifiers

Medical identifiers for Douglas Peter Davidson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174294938NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 62399 (California)Primary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Adventist Health Lodi MemorialLodi, CAHospital
Woodland Memorial HospitalWoodland, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Clinic Services Of California Medical Group Inc781020971565
Dignity Health Medical Foundation78108006611211

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Douglas Peter Davidson Jr allows following entities to bill medicare on his behalf.
Entity NameCep America - California
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023063542
PECOS PAC ID: 6103739131
Enrollment ID: O20031106000520
Entity NameDignity Health Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700803418
PECOS PAC ID: 7810800661
Enrollment ID: O20031107000709
Entity NameTeam Physicians of California Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447288345
PECOS PAC ID: 8224945084
Enrollment ID: O20040920000880
Entity NameClinic Services of California Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578958450
PECOS PAC ID: 7810209715
Enrollment ID: O20150707001394

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Douglas Peter Davidson Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Douglas Peter Davidson Jr, PA
38332 Maple Ct,
Murrieta, CA 92562-3406

Ph: (951) 816-8970		Douglas Peter Davidson Jr, PA
50 Acacia Ave,
San Rafael, CA 94901-2230

Ph: (951) 816-8970

Reviews and Comments


Physician Assistant Nurses in San Rafael, CA

Miranda Minh-han Nguyen,
Physician Assistant
Medicare: May Accept Medicare Assignments
Practice Location: 4000 Civic Center Dr, San Rafael, CA 94903
Phone: 415-492-3333    
Miguel Serrato, ATC OT-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 50 Acacia Ave, San Rafael, CA 94901
Phone: 415-457-4440    
Page Tenley, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 2 H St, San Rafael, CA 94901
Phone: 415-459-4907    
Phyllis Won, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 99 Montecillo Rd, San Rafael, CA 94903
Phone: 415-444-2000    
Thi Tran, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 50 Acacia Ave, San Rafael, CA 94901
Phone: 415-457-4440    
Chantilay Ruffin,
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 50 Acacia Ave, Meadowlands 302, San Rafael, CA 94901
Phone: 415-482-3571    
Nicole M Newhauser, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 4000 Civic Center Dr Ste 209, San Rafael, CA 94903
Phone: 415-925-8963    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.