Douglas Peter Davidson Jr., PA
NPI 1174294938ActiveIndividual· Physician Assistant· San Rafael, CA
Physician Assistant (PA) with Dignity Health Medical Foundation and 1 other group, practicing in San Rafael, California. 124 Medicare patients in 2024, $12,130 paid; nearly all of their 236 Part D prescriptions were generic (92%). Lists Adventist Health Lodi Memorial and 1 other hospital as hospital affiliations.
Overview
| NPI | 1174294938 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | No |
| NPI issued | Sep 22, 2021 |
| Last updated in NPPES | Mar 7, 2023 |
| Certified by provider | Mar 7, 2023 |
| Reactivated | Dec 5, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 62399 | CA |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (CA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 124 |
|---|---|
| Services billed | 256 across 29 procedure codes |
| Paid by Medicare | $12,130 |
Part D prescriptions in 2024
| Prescriptions (claims) | 236 · 244 30-day fills |
|---|---|
| Patients | 151 |
| Total drug cost | $4,786 |
| Generic share | 92% of claims |
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Dignity Health Medical FoundationFolsom, CA · 1,184 clinicians
- Clinic Services of California Medical Group IncColton, CA · 61 clinicians
Hospital affiliations
- Adventist Health Lodi MemorialLodi, CA
- Woodland Memorial HospitalWoodland, CA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Physician Assistant providers in San Rafael
- 1659563849
- 1780308890
- 1255671186
- 1659833291
- 1992368419
- 1407135957
- 1225863632
- 1891417390
- 1407654767
- 1487114534
- 1295342905
- 1720693682