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DR. DOUGLAS L JICHA MD
NPI 1306879325
Surgery - Vascular Surgery in Scarborough, ME

Active since July 10, 2006PECOS Enrolled
306 US ROUTE 1, BLDG C, SCARBOROUGH, ME 04074(207) 885-5742(207) 885-1494 Get Directions Write a Review

NPPES record last updated: November 3, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 3, 2021, Feb 1, 2021 (2 updates tracked since 2021).

About Dr. Douglas L Jicha Md NPPES

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

DR. DOUGLAS L JICHA MD (NPI 1306879325) is an individual vascular surgery provider in Scarborough, Maine, licensed in Maine (006810) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306879325
Entity TypeIndividualMale
Primary Taxonomy2086S0129X
Provider Legal NameDR. DOUGLAS L JICHACredential: MD
Location Address306 US ROUTE 1, BLDG CScarborough, ME 04074
Mailing Address306 Us Route 1, Bldg CScarborough, ME 04074 · (207) 885-5742 · Fax (207) 885-1494
Phone(207) 885-5742
Fax(207) 885-1494
Sole ProprietorNo
Enumeration DateJuly 10, 2006
Last NPPES UpdateNovember 3, 20212 updates tracked since enumeration
NPPES CertifiedNovember 3, 2021
✔ NPI 1306879325 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0129X
License✔ Licensed in ME · 006810
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
306 US ROUTE 1, Scarborough, ME 04074
Open in Google Maps ↗

Other Identifiers 1

Medicaid132540000ME

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Douglas L Jicha Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Douglas Jicha reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Providence Medical Foundation
2,563 mi
Urology
19333 BEAR VALLEY RD, SUITE 106
Apple Valley, CA 92308
  • Reassigned Medicare billing, California enrollment
  • 1,699 clinicians in this Medicare group
NPI 1053616706 (760) 240-5505

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04074 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
$86.72 typical visit price
range $56.28 – $169.96
Typical copayment $21.68 (range $14.07 – $42.49)
Most-billed visit code 99203
Established Patient
$70.13 typical visit price
range $18.22 – $138.92
Typical copayment $17.53 (range $4.55 – $34.73)
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.

Other Providers at the Same Location NPPES 4

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

MR. VINCENT PAUL HERZOG D.O.
Physical Medicine & Rehabilitation
306 US ROUTE 1
SCARBOROUGH, ME 04074
Cumberland County (207) 883-3434
MAINE REHABILITATIVE HEALTHCARE, LLC
Physical Medicine & Rehabilitation
306 US ROUTE 1, BUILDING B SOUTH
SCARBOROUGH, ME 04074
Cumberland County (207) 883-3434
DR. ROBERT JAMES MITCHELL D.D.S.
Dentist
306 US ROUTE 1, BLDG. C-1
SCARBOROUGH, ME 04074
Cumberland County (207) 510-0033
DR. LISA PETER HOWARD DDS, MS
Dentist (Orthodontics and Dentofacial Orthopedics)
306 US ROUTE 1, STE D1
SCARBOROUGH, ME 04074
Cumberland County (207) 885-1005

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 Jicha's NPI number?

The NPI number for Douglas Jicha is 1306879325. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Where is Douglas Jicha located?

Douglas Jicha practices at 306 Us Route 1 Bldg C, Scarborough, ME 04074. The listed phone number is (207) 885-5742.

What is Douglas Jicha's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Is Douglas Jicha enrolled in Medicare?

Yes. Douglas Jicha is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Douglas Jicha's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Jicha reassigns Medicare benefits to Providence Medical Foundation (Apple Valley, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Douglas Jicha's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Douglas Jicha was last updated on November 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.