Individual provider Active NPI

Terry Lynn Doherty, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1174248165
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN161828 Issued in MA
Practice address
55 Fruit St # 1500
Boston, MA 02114-2621
Phone
(617) 726-3874
Fax
(617) 643-1384
NPI assigned
Oct 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AG07220221 MA
Nurse Practitioner 363L00000X RN161828 MA Primary

Addresses

Primary practice location

55 Fruit St # 1500
Boston, MA 02114-2621

Mailing address

298 Lincoln St
Duxbury, MA 02332-3119
Phone (339) 793-3154

Other practice location 1

298 Lincoln St
Duxbury, MA 02332-3119
Phone (339) 793-3154

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL tdoherty@partners.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20230717000391 MA Practitioner - Nurse Practitioner 6305206830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN161828MAMDNurse Practitioner
AG07220221MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jul 1, 2023 Accepting new patients

Locations

55 Fruit St
#1500
Boston, MA 02114
Phone (617) 724-3842

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: doherty.terry.mgh@direct.partners.masshiway.net

Organizations & group practices 3

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 1

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": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1174248165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 LINCOLN ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023323119",
            "telephone_number": "339-793-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST # 1500",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-3874",
            "fax_number": "617-643-1384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "298 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Duxbury",
            "state": "MA",
            "postal_code": "023323119",
            "country_code": "US",
            "telephone_number": "339-793-3154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "TERRY",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "AG07220221",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN161828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tdoherty@partners.org",
            "affiliation": "N",
            "address_1": "298 Lincoln St",
            "city": "Duxbury",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023323119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.