Trevor James Doherty

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

023899 Issued in NY

Practice address

5141 Broadway # 2FW-095
New York, NY 10034-1159

Phone

(212) 932-5218

Fax

(212) 932-5258

NPI assigned

May 6, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: trd9037@direct.nyp.org
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  NPD (past)
• Trustees of Columbia University in the Department of Otolaryngology

  • Specialist
  • New York, NY
  • NPI 1801074315
  NPD (past)

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1043875974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 STILLSON RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253212",
            "telephone_number": "203-209-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5141 BROADWAY # 2FW-095",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341159",
            "telephone_number": "212-932-5218",
            "fax_number": "212-932-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "TREVOR",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-06",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James J Doherty, LCSW-R
• Laura Gay Doherty, LMSW
• Liam Doherty
• Madison Shae Doherty, PT, DPT
• Tara Doherty
• Daniel Dohmann, NP
• Sarah Dohrmann, LMSW
• Dorothy Ann Dojlidko, ANP
• Maria Dokaj
• Julia Jean Dokko, MD

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.