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

NPI Status: Active since January 10, 2006

Contact Information

3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX
ZIP 78234
Phone: (210) 916-5666

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  • Individual
  • Male
  • Physician Assistant
  • Surgical
  • PECOS Enrolled
  • Medicare Quality Reporting

About DOUGLAS DUSENBERRY

This page provides the complete NPI Profile along with additional information for Douglas Dusenberry, a provider established in Jbsa Ft Sam Houston, Texas with a medical specialization in Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1790764678 assigned on January 2006. The practitioner's primary taxonomy code is 363AS0400X with license number PA04877 (TX). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1790764678
Provider Name
MR. DOUGLAS IVAN DUSENBERRY PA-C
Gender
Male
Entity Type
Individual
Location Address
3551 ROGER BROOKE DR JBSA FT SAM HOUSTON, TX 78234
Location Phone
(210) 916-5666
Mailing Address
3851 ROGER BROOKE DR BROOKE ARMY MEDICAL CENTER FORT SAM HOUSTON, TX 78234
Mailing Phone
(210) 916-0517
Is Sole Proprietor?
Yes
Enumeration Date
01-10-2006
Last Update Date
08-16-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Surgical

Taxonomy Code
363AS0400X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
PA04877
License State
TX

Medicare Participation & PECOS Enrollment Status

Douglas Dusenberry is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1790764678, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
0
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
6
Unchanged
Pos 7
4
Doubled → 8
Pos 8
6
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 4 → 8 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 8 + 0 + 1 + 4 + 6 + 8 + 6 + 1 + 4 + 24 = 72

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1790764678.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Pediatrics
3551 ROGER BROOKE DR, DEPARTMENT OF PEDIATRICS/ADOLESCENT MEDICINE
FORT SAM HOUSTON, TX 78234
Pediatrics (Pediatric Cardiology)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Pediatrics (Neonatal-Perinatal Medicine)
3551 ROGER BROOKE DR, NEONATOLOGY
FORT SAM HOUSTON, TX 78234
Nurse Practitioner (Primary Care)
3551 ROGER BROOKE DR, DEPARTMENT OF PEDIATRICS/ADOLESCENT MEDICINE
FORT SAM HOUSTON, TX 78234
Student in an Organized Health Care Education/Training Program
3551 ROGER BROOKE DR, MCHE/ME
FORT SAM HOUSTON, TX 78234
Student in an Organized Health Care Education/Training Program
3551 ROGER BROOKE DR, MCHE-QD(CREDS)
FORT SAM HOUSTON, TX 78234
Occupational Therapist
3551 ROGER BROOKE DR, MCHE-QD (CREDS)
FORT SAM HOUSTON, TX 78234
Internal Medicine (Infectious Disease)
3551 ROGER BROOKE DR, MCHE-QD, BLDG 3600
FORT SAM HOUSTON, TX 78234
Urology
3551 ROGER BROOKE DR, MCHE-SDU, BUILDING 3600
SAN ANTONIO, TX 78234
Occupational Therapist
3551 ROGER BROOKE DR
SAN ANTONIO, TX 78234
Occupational Therapist
3551 ROGER BROOKE DR, MCHE-QD (CREDS)
SAN ANTONIO, TX 78234
Internal Medicine (Infectious Disease)
3551 ROGER BROOKE DR, MCHE-MDI
FORT SAM HOUSTON, TX 78234
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)
3551 ROGER BROOKE DR, RM 114-13 (OCCUPTIONAL HEALTH/PREVENTIVE MEDICINE)
SAN ANTONIO, TX 78234
Physician Assistant
3551 ROGER BROOKE DR, BROOKE ARMY MEDICAL CENTER
FORT SAM HOUSTON, TX 78234
Hospitalist
3551 ROGER BROOKE DR, BROOKE ARMY MEDICAL CENTER
FORT SAM HOUSTON, TX 78234
Student in an Organized Health Care Education/Training Program
3551 ROGER BROOKE DR, MCHE/ME
SAN ANTONIO, TX 78234
Student in an Organized Health Care Education/Training Program
3551 ROGER BROOKE DR, MCHE/ME
SAN ANTONIO, TX 78234
Internal Medicine (Endocrinology, Diabetes & Metabolism)
3551 ROGER BROOKE DR, ATTN: MCHE-MDE
FORT SAM HOUSTON, TX 78234
Internal Medicine (Pulmonary Disease)
3551 ROGER BROOKE DR, BROOKE ARMY MEDICAL CENTER
FORT SAM HOUSTON, TX 78234
Psychiatry & Neurology (Neuromuscular Medicine)
3551 ROGER BROOKE DR, BROOKE ARMY MEDICAL CENTER DEPT OF NEUROLOGY
SAN ANTONIO, TX 78234

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790764678, enumerated as an "individual" on January 10, 2006.

The provider is located at 3551 ROGER BROOKE DR JBSA FT SAM HOUSTON, TX 78234 and the phone number is (210) 916-5666.

Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.