David R Dougherty, DO

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

190466-1 Issued in NY

Practice address

295 Essjay Rd
Williamsville, NY 14221-8216

Phone

(716) 630-1045

Fax

(716) 630-1451

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1235196189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215782",
            "telephone_number": "716-630-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 ESSJAY RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218216",
            "telephone_number": "716-630-1045",
            "fax_number": "716-630-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NY",
            "license": "190466-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010047601",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060030225",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH AMERICAN PREFERRED",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01503039",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "2706325",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000523376001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2504875",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "Y",
            "affiliationName": "Buffalo Medical Group, P.C.",
            "address_1": "295 Essjay Rd",
            "city": "Williamsville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142218216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon Charmaine Donovan, FNP
• Suzanne Donovan, LCSW
• David John Dormandy Jr., D.O
• Jack William Dormer, PA
• Penny Dortch, LPN
• Jacquelyn M Dougherty, OD
• Harold O Douglass Jr., M.D.
• Therese Dowd, LPN
• Anne Marie Downey, OD
• Angela R Downing, M.S.

• Medical Oncology Physician in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Medical Oncology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.