Active NPI
Bret Randall Dougherty, M.D.
- Family Medicine Physician
- Salinas, CA
National Provider Identifier
1154334407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A75494
- Practice address
- 559 E Alisal St
Suite 201
Salinas, CA 93905-2516 - Phone
- (831) 769-8800
- Fax
- (831) 422-9312
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A75494 | CA | Primary |
Addresses
Primary practice location
559 E Alisal St
Suite 201
Salinas, CA 93905-2516
Mailing address
559 E Alisal St
Suite 201
Salinas, CA 93905-2516
Phone (831) 769-8800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FHC70832F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A75494 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Monterey | Past | Accepting new patients | |
| Monterey County Behavioral Health Division | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Salinas, CA
- NPI 1508629171
-
- Community/Behavioral Health Agency
- Salinas, CA
- NPI 1730211178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1154334407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "559 E ALISAL ST",
"address_2": "SUITE 201",
"city": "SALINAS",
"state": "CA",
"postal_code": "939052516",
"telephone_number": "831-769-8800",
"fax_number": "831-422-9312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "559 E ALISAL ST",
"address_2": "SUITE 201",
"city": "SALINAS",
"state": "CA",
"postal_code": "939052516",
"telephone_number": "831-769-8800",
"fax_number": "831-422-9312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGHERTY",
"first_name": "BRET",
"middle_name": "RANDALL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A75494",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC70832F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salinas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.