NPIMap

Individual provider Active NPI

Andrew Doherty, M.D.

  • Obstetrics & Gynecology Physician
  • Brighton, MI
National Provider Identifier
1104114040
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301099510 Issued in MI
Practice address
2305 Genoa Business Park Dr Ste 220
Brighton, MI 48114-7005
Phone
(810) 494-6860
Fax
(810) 229-7012
NPI assigned
Jul 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 4301099510 MI
Obstetrics & Gynecology Physician 207V00000X 4301099510 MI Primary

Addresses

Primary practice location

2305 Genoa Business Park Dr Ste 220
Brighton, MI 48114-7005

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150623001070 MI Practitioner - Obstetrics/Gynecology 6406088269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

2305 Genoa Bus Park Dr
Brighton, MI 48114-7005

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

620 Byron Rd
Howell, MI 48843-1002

775 S Main St
Chelsea, MI 48118-1383

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Obstetrics & Gynecology Current Accepting new patients
St Mary Mercy Hospital Professional CurrentSince Nov 1, 2019 Accepting new patients
St Mary Mercy Hospital Crna Current Accepting new patients
St Mary Mercy Hospital Professional CurrentSince Nov 1, 2019 Accepting new patients
Iha Health Services Corporation CurrentSince Aug 1, 2015 Accepting new patients
Iha Health Services Corporation Past Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients
Iha Health Services Corporation Obstetrics & Gynecology Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

Interoperability endpoints

  • Direct secure messaging: adoherty37044@direct.trinity-health.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1104114040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 GENOA BUSINESS PARK DR STE 220",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147005",
            "telephone_number": "810-494-6860",
            "fax_number": "810-229-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-13",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "MI",
            "license": "4301099510",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301099510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.