Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MALCOLM DOUGLAS PA
NPI 1730852021
Physician Assistant in Nellis Afb, NV

Q: What is Malcolm Douglas's NPI number?

The NPI number for Malcolm Douglas is 1730852021. It was assigned to this individual provider in the NPPES registry on August 1, 2021.

Q: What is Malcolm Douglas's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Malcolm Douglas was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 33 days 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.

Active since August 01, 2021PECOS EnrolledAccepts Medicare Assignment

4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-2273(999) 999-9999 Get Directions Write a Review

NPPES record last updated: July 17, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 17, 2026, May 11, 2026, Apr 2, 2025 and 2 more (5 updates tracked since 2022).

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About Malcolm Douglas Pa NPPES

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

MALCOLM DOUGLAS PA (NPI 1730852021) is an individual physician assistant in Nellis Afb, Nevada, licensed in Nevada (PA2613) and active in the NPI registry since August 2021. He is enrolled in Medicare PECOS and is a graduate of Touro Un Col Of Osteopathic Medicine, Henderson (2021).

NPPES Registry Identity

NPI1730852021

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMALCOLM DOUGLASCredential: PA

Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6600

Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6600 · (702) 653-2273 · Fax (999) 999-9999

Phone(702) 653-2273

Fax(999) 999-9999

Sole ProprietorNo

Medical School CMSTouro Un Col Of Osteopathic Medicine, HendersonGraduated 2021

Enumeration DateAugust 1, 2021

Last NPPES UpdateJuly 17, 20265 updates tracked since enumeration

NPPES CertifiedJuly 17, 2026

✔ NPI 1730852021 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NV · PA2613

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health.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

Malcolm Douglas 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 ID7416392923

PECOS Enrollment IDI20240223002593

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

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.

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.

25 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89191 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

$88.51 typical visit price

range $57.07 – $173.24

Typical copayment $22.12 (range $14.26 – $43.31)

Most-billed visit code 99203

Established Patient

$71.14 typical visit price

range $18.27 – $140.96

Typical copayment $17.78 (range $4.56 – $35.24)

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 20

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

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