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MR. DOUGLAS IVAN DUSENBERRY PA-C
NPI 1790764678
Physician Assistant - Surgical in Jbsa Ft Sam Houston, TX

Active since January 10, 2006PECOS Enrolled
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234(210) 916-5666 Get Directions Write a Review

NPPES record last updated: August 16, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 16, 2021, Apr 19, 2018 (2 updates tracked since 2018).

About Mr. Douglas Ivan Dusenberry Pa-c NPPES

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

MR. DOUGLAS IVAN DUSENBERRY PA-C (NPI 1790764678) is an individual surgical provider in Jbsa Ft Sam Houston, Texas, licensed in Texas (PA04877) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790764678
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. DOUGLAS IVAN DUSENBERRYCredential: PA-C
Location Address3551 ROGER BROOKE DRJbsa Ft Sam Houston, TX 78234-4504
Mailing Address3851 Roger Brooke Dr, Brooke Army Medical CenterFort Sam Houston, TX 78234-4501 · (210) 916-0517
Phone(210) 916-5666
Sole ProprietorYes
Enumeration DateJanuary 10, 2006
Last NPPES UpdateAugust 16, 20212 updates tracked since enumeration
NPPES CertifiedAugust 16, 2021
✔ NPI 1790764678 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 TX · PA04877
3551 ROGER BROOKE DR, Jbsa Ft Sam Houston, TX 78234
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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)

Mr. Douglas Ivan Dusenberry Pa-c 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.

JANET JONES SIMS CRNA
Nurse Anesthetist, Certified Registered
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (253) 223-6272
JAMES KENNEDY HARDIN PA-C
Physician Assistant
3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX 78234
Bexar County (210) 295-4996
DR. DANIEL VICTOR-CALVIN HAMMOND M.D.
Pediatrics (Pediatric Endocrinology)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 916-3020
JESSICA FULLER LCSW
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 808-1859
DR. JASON ROBERT HALL M.D.
Neurological Surgery
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 539-9582
MRS. KATHRYN ELAINE HELLAND LCSW
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 539-9582
DR. HALWARD BLEGEN IV DO
Ophthalmology
3551 ROGER BROOKE DR
JBSA FORT SAM HOUSTON, TX 78234
Bexar County (210) 220-7419
KOLE HOLLAND SPAULDING M.D.
Emergency Medicine (Emergency Medical Services)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 539-9582

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 Dusenberry's NPI number?

The NPI number for Douglas Dusenberry is 1790764678. It was assigned to this individual provider in the NPPES registry on January 10, 2006.

Where is Douglas Dusenberry located?

Douglas Dusenberry practices at 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234. The listed phone number is (210) 916-5666.

What is Douglas Dusenberry's specialty?

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

Is Douglas Dusenberry enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Douglas Dusenberry was last updated on August 16, 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.