NPIMap

Individual provider Active NPI

Michael James Dougherty, MD

  • Family Medicine Physician
  • Merritt Island, FL
National Provider Identifier
1245735133
Registry record updated Sep 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME148451 Issued in FL
Practice address
450 E Merritt Island Cswy # 600
Merritt Island, FL 32952-3503
Phone
(321) 452-4442
Fax
(321) 452-9138
NPI assigned
Mar 24, 2018
Last updated
Sep 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME148451 FL Primary

Addresses

Primary practice location

450 E Merritt Island Cswy # 600
Merritt Island, FL 32952-3503

Mailing address

2675 Winkler Ave Ste 200
Fort Myers, FL 33901-9328
Phone (877) 856-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211104000265 FL Practitioner - Family Practice 2769731660 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RHG of Florida PAGroup PAC ID 7416479761, 22 clinicians
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

450 E Merritt Island Cswy
E600 Merritt Island Family Medicine
Merritt Island, FL 32952-3503
Phone (321) 452-4470

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc. Family Medicine CurrentSince Oct 15, 2021 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 15, 2021 Accepting new patients
RHG of Florida PA Family Medicine CurrentSince Jan 16, 2025 Accepting new patients

Locations

240 N Wickham Rd
Ste 304
Melbourne, FL 32935
Phone (321) 308-5050

2404 N Courtenay Pkwy
#D
Merritt Island, FL 32953
Phone (321) 261-0055

450 E Merritt Island Cswy
#600
Merritt Island, FL 32952
Phone (321) 453-3638

450 E Merritt Island Cswy
Ste E600
Merritt Island, FL 32952

8000 Ron Beatty Blvd
Ste A-3
Sebastian, FL 32976
Phone (772) 664-1388

9 Galen St
Fl 1
Watertown, MA 02472

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1521849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788652800000",
    "number": "1245735133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019328",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E MERRITT ISLAND CSWY # 600",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523503",
            "telephone_number": "321-452-4442",
            "fax_number": "321-452-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-24",
        "last_updated": "2026-09-06",
        "certification_date": "2026-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME148451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.