Roy A Doerhoff, MD
Individual provider Active NPI Anesthesiology Physician · Chesterfield, MO
NPI 1235249384 · NPPES record last updated Aug 15, 2023
Key facts
- NPI
- 1235249384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 2002017790 (MO)
- Practice address
- 232 S Woods Mill Rd
Chesterfield, MO 63017 - Phone
- (314) 205-6917
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Blessing Hospital
Practice addresses (Care Compare)
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400
Hospital & facility affiliations
- Blessing Hospital
- Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040726001038 | MO | Practitioner - Anesthesiology | 1153391446 | Reassigns benefits to 1 organization |
| I20230921001521 | IL | Practitioner - Anesthesiology | 1153391446 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036148287 | IL | MD | Anesthesiology Physician |
| 2002017790 | MO | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Anesthesia Care PC | Anesthesiology | Current |
Accepting new patients |
| Blessing Hospital | Anesthesiology | Current |
Accepting new patients |
| Blessing Hospital | Current |
Accepting new patients |
Locations
1005 Broadway St
Quincy, IL 62301
232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030
Interoperability endpoints
- https://fhir.blessinghospital.com/R4/open-Prod
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036148287 | IL | |
| Anesthesiology Physician | 207L00000X | 2002017790 | MO | Yes |
Addresses
Primary practice location
232 S Woods Mill Rd
Chesterfield, MO 63017
Mailing address
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-1200
Other practice location 1
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-1200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208744607 | Medicaid | MO |
NPI Registry JSON
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1235249384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012834",
"telephone_number": "217-223-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 S WOODS MILL RD",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "63017",
"telephone_number": "314-205-6917"
}
],
"practiceLocations": [
{
"address_1": "1005 Broadway St",
"address_purpose": "LOCATION",
"city": "Quincy",
"state": "IL",
"postal_code": "623012834",
"country_code": "US",
"telephone_number": "217-223-1200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOERHOFF",
"first_name": "ROY",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036148287",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MO",
"license": "2002017790",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208744607",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, MO
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All providers in Chesterfield, MO · Anesthesiology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.