Kathleen Mary Dougherty

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1608 Cool Creek Dr
Carmel, IN 46033-2321

Phone

(317) 696-1099

NPI assigned

Jan 10, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013
• Columbia Memorial Hospital Hospital, Hudson, NY, CCN 330094

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688
  Medicare reassignment NPD
• Albany Medical College

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Niskayana, NY
  • NPI 1154973071

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1376577247
  Care Compare affiliation
• Albany Medical Center Hospital

  • Clinical Medical Laboratory
  • Albany, NY
  • NPI 1700204641

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • Radiology Clinic/Center
  • Albany, NY
  • NPI 1811448657

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1811917461
  Care Compare affiliation
• Columbia Memorial Hospital

  • General Acute Care Hospital
  • Hudson, NY
  • NPI 1528024718
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1013621382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 COOL CREEK DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460332321",
            "telephone_number": "317-696-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 COOL CREEK DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460332321",
            "telephone_number": "317-696-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdougherty5@sycamores.indstate.edu",
            "affiliation": "Y",
            "affiliationName": "Indiana State University",
            "address_1": "1608 Cool Creek Dr",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460332321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathleen Mary Dorato, RPH
• Megan Rose Dorsa, PA
• Robert H. Dorwart, M.D.
• Bethany Doseck
• Claire Dougherty, DO
• Nicholas Xavier Dougherty
• Madison Lynn Dowden
• James A Dowell, LCSW
• Hannah Elise Downey, O.D.
• Matthew Stephen Downey, MSW, LCSW

• Student in an Organized Health Care Education/Training Program in Carmel, IN
• Providers in Carmel, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.