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DR. DOUGLAS MERRITT DOWNEY M.D.
NPI 1083775803
Surgery in Cordele, GA

Active since December 13, 2006PECOS EnrolledAccepts Medicare Assignment
416 E 4TH AVE STE A, CORDELE, GA 31015(229) 271-4659(229) 271-4654 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018 (2 updates tracked since 2018).

About Dr. Douglas Merritt Downey M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOUGLAS MERRITT DOWNEY M.D. (NPI 1083775803) is an individual surgery provider in Cordele, Georgia, licensed in Georgia (077727) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Madison, and is a graduate of University Of Alabama School Of Medicine (2003).

NPPES Registry Identity

NPI1083775803
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. DOUGLAS MERRITT DOWNEYCredential: M.D.
Location Address416 E 4TH AVE STE ACordele, GA 31015-3729
Mailing AddressPo Box 5007Cordele, GA 31010-5007 · (229) 271-4659 · Fax (229) 271-4654
Phone(229) 271-4659
Fax(229) 271-4654
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2003
Enumeration DateDecember 13, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1083775803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in GA · 077727✔ Licensed in ME · MD19112✔ Licensed in AL · MD.26147
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

416 E 4TH AVE STE A, Cordele, GA 31015
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Secondary Practice Location 1

Location 11041 Balch Rd, Ste 350Madison, AL 35758-8343 · Phone (256) 265-5951 · Fax (256) 265-5952

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Douglas Merritt Downey M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759529472
PECOS Enrollment IDI20140626002277
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
46 services45 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
40 services28 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
30 services30 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
24 services20 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
15 services15 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
13 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31015 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
2 suppliers18 claims530 services$4.58 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Downey's NPI number?

The NPI number for Douglas Downey is 1083775803. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Where is Douglas Downey located?

Douglas Downey practices at 416 E 4th Ave Ste A, Cordele, GA 31015. The listed phone number is (229) 271-4659.

What is Douglas Downey's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Douglas Downey enrolled in Medicare?

Yes. Douglas Downey is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Douglas Downey accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 3 other insurers list Douglas Downey as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Douglas Downey was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.