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DR. DOUGLAS W MIDCAP DO
NPI 1992701197
Family Medicine in Wheeling, WV

Active since June 22, 2005PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
1000 NATIONAL RD, WHEELING, WV 26003(304) 217-3520(304) 217-3524 Get Directions Write a Review

NPPES record last updated: September 19, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 19, 2022, Jan 10, 2021 (2 updates tracked since 2021).

About Dr. Douglas W Midcap Do NPPES

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

DR. DOUGLAS W MIDCAP DO (NPI 1992701197) is an individual family medicine provider in Wheeling, West Virginia, licensed in West Virginia (1358) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with West Virginia University Hospitals, Inc, and is a graduate of West Virginia School Of Osteopathic Medicine (1991).

NPPES Registry Identity

NPI1992701197
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DOUGLAS W MIDCAPCredential: DO
Location Address1000 NATIONAL RDWheeling, WV 26003-5774
Mailing Address2000 Eoff StWheeling, WV 26003-3823 · (304) 234-8663 · Fax (304) 234-8960
Phone(304) 217-3520
Fax(304) 217-3524
Sole ProprietorNo
Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 1991
Enumeration DateJune 22, 2005
Last NPPES UpdateSeptember 19, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2022
✔ NPI 1992701197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WV · 1358
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1000 NATIONAL RD, Wheeling, WV 26003
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Other Identifiers 2

Medicaid0053416000WV
Medicaid2426842OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Dr. Douglas W Midcap Do 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 ID7810882123
PECOS Enrollment IDI20120904000525
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 9

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.
392 services225 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
136 services136 patients
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes G0446
This is a yearly, personal consultation focused on behaviors affecting heart health. It lasts 15 minutes and may cover topics like diet, exercise, and stress management. It's about learning healthy habits to protect your heart.
53 services53 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
26 services25 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
24 services24 patients
Face-to-face behavioral counseling for obesity, 15 minutes G0447
This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.
20 services20 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

West Virginia University Hospitals, Inc

Acute Care Hospitals · Morgantown, WV
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510001
Location1 Medical Center DriveMorgantown, WV 26506 · Monongalia County
Emergency services Birthing friendly

Reynolds Memorial Hospital

Acute Care Hospitals · Glen Dale, WV
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510013
Location800 Wheeling AveGlen Dale, WV 26038 · Marshall County
Emergency services Birthing friendly

Weirton Medical Center, Inc

Acute Care Hospitals · Weirton, WV
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number510023
Location601 Colliers WayWeirton, WV 26062 · Hancock County
Emergency services

Wheeling Hospital, Inc

Acute Care Hospitals · Wheeling, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number510050
Location1 Medical ParkWheeling, WV 26003 · Ohio County
Emergency services Birthing friendly

Wetzel County Hospital

Acute Care Hospitals · New Martinsville, WV
OwnershipGovernment - Local
CMS Certification Number510072
Location#3 East Benjamin DriveNew Martinsville, WV 26155 · Wetzel County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26003 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
12 suppliers29 claims56 services$5.29 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers11 claims16 services$1.16 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
2 suppliers11 claims1,480 services$1.64 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier17 claims17 services$3.66 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers23 claims23 services$91.22 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers31 claims31 services$183.16 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

WHEELING HOSPITAL INC
Family Medicine
1000 NATIONAL RD
WHEELING, WV 26003
Ohio County (304) 234-1971
BROOKE M HULL FNP-BC
Nurse Practitioner (Family)
1000 NATIONAL RD
WHEELING, WV 26003
Ohio County (304) 234-1971
MICHAEL E WILSON DO
Family Medicine
1000 NATIONAL RD
WHEELING, WV 26003
Ohio County (304) 234-1971

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 Midcap's NPI number?

The NPI number for Douglas Midcap is 1992701197. It was assigned to this individual provider in the NPPES registry on June 22, 2005.

Where is Douglas Midcap located?

Douglas Midcap practices at 1000 National Rd, Wheeling, WV 26003. The listed phone number is (304) 217-3520.

What is Douglas Midcap's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Douglas Midcap enrolled in Medicare?

Yes. Douglas Midcap is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Douglas Midcap accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 2 other insurers list Douglas Midcap as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Douglas Midcap affiliated with any hospitals?

According to CMS data, Douglas Midcap is affiliated with West Virginia University Hospitals, Inc, Reynolds Memorial Hospital, Weirton Medical Center, Inc, Wheeling Hospital, Inc and Wetzel County Hospital.

When was this NPI record last updated?

The NPPES record for Douglas Midcap was last updated on September 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.