Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Ronald Jason Douglas, PA

Individual provider Physician Assistant · NPI 1356312482

Mr. Ronald Jason Douglas, PA is a Physician Assistant in Fort Wayne, Indiana. Qualified in 1997, 29 years ago. Practices with Fort Wayne Radiology Associates LLC, a 35-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
29
Licensed in
IN
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5001 US Highway 30 W Ste D
Fort Wayne, IN 46818-9701
Phone: (260) 432-1568
Fax: (260) 432-4969
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10000680A (IN)

Record details

NPI number1356312482
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 27, 2006
Last updated in NPPESNovember 17, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Fort Wayne Radiology Associates Llc — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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