MR. DOUGLAS S. TANAKA PA
NPI 1225287725
Physician Assistant - Surgical in Fresno, CA

Q: What is Douglas Tanaka's NPI number?

The NPI number for Douglas Tanaka is 1225287725. It was assigned to this individual provider in the NPPES registry on September 9, 2008.

Q: What is Douglas Tanaka's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Douglas Tanaka was last updated on January 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 09, 2008PECOS EnrolledAccepts Medicare Assignment

2823 FRESNO ST, FRESNO, CA 93721(559) 459-4090 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mr. Douglas S. Tanaka Pa NPPES

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

MR. DOUGLAS S. TANAKA PA (NPI 1225287725) is an individual surgical provider in Fresno, California, licensed in California (PA19873) and active in the NPI registry since September 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1225287725

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameMR. DOUGLAS S. TANAKACredential: PA

Location Address2823 FRESNO STFresno, CA 93721-1324

Mailing Address4910 E Clinton Way, Suite 101Fresno, CA 93727-1560 · (559) 443-2682 · Fax (559) 443-2681

Phone(559) 459-4090

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateSeptember 9, 2008

Last NPPES UpdateJanuary 3, 2022

✔ NPI 1225287725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in CA · PA19873

2823 FRESNO ST, Fresno, CA 93721

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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

Mr. Douglas S. Tanaka Pa 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 ID9830253319

PECOS Enrollment IDI20090128000141

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.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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