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MARK DOUGLASS MD
NPI 1528809910
Student in an Organized Health Care Education/Training Program in Oakland, CA

Active since June 01, 2024PECOS Enrolled
275 W MACARTHUR BLVD, OAKLAND, CA 94611(510) 752-1000 Get Directions Write a Review

NPPES record last updated: June 1, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mark Douglass Md NPPES

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

MARK DOUGLASS MD (NPI 1528809910) is an individual student in an organized health care education/training program in Oakland, California and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1528809910
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMARK DOUGLASSCredential: MD
Location Address275 W MACARTHUR BLVDOakland, CA 94611-5641
Mailing Address275 W Macarthur BlvdOakland, CA 94611-5641
Phone(510) 752-1000
Sole ProprietorNo
Enumeration DateJune 1, 2024
NPPES CertifiedJune 1, 2024
✔ NPI 1528809910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
275 W MACARTHUR BLVD, Oakland, CA 94611
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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 (PECOS)

Mark Douglass 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.

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.

DR. ANNA C. MORGAN MD
Specialist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. TRANG H. LA MD
Radiology (Radiation Oncology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. AMIN MATIN M.D., M.P.H.
Radiology (Diagnostic Radiology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (925) 295-5758
SUCHETA KORWAR MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
MR. MATTHEW GABRIELSON D.P.T.
Physical Therapist (Orthopedic)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-6221
MALORIE HACKER MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
RENEE L. PERRY DO
Obstetrics & Gynecology
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
HERPRIT KAUR MAHAL MD
Hospitalist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000

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 Mark Douglass's NPI number?

The NPI number for Mark Douglass is 1528809910. It was assigned to this individual provider in the NPPES registry on June 1, 2024.

Where is Mark Douglass located?

Mark Douglass practices at 275 W Macarthur Blvd, Oakland, CA 94611. The listed phone number is (510) 752-1000.

What is Mark Douglass's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mark Douglass enrolled in Medicare?

Yes. Mark Douglass is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mark Douglass was last updated on June 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.