Susan L Doughty, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP13911 Issued in CA

Practice address

39500 Liberty Street
Tri City Health Center
Fremont, CA 94538

Phone

(510) 770-8133

Fax

(510) 770-8140

NPI assigned

Jun 11, 2006

Last updated

Aug 2, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Columbia University College of Physicians and Surgeons, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Community HealthGroup PAC ID 1658349824, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdoughty287389@direct.ochin.org

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.

• Bay Area Community Health

  dba BACH School Mobile Health Clinic II

  • Federally Qualified Health Center (FQHC)
  • Fremont, CA
  • NPI 1780054379
  Medicare reassignment Care Compare group NPD
• Bay Area Community Health

  dba Aborn Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Fremont, CA
  • NPI 1184791998
  NPD

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1285676759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39500 LIBERTY STREET",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94538",
            "telephone_number": "510-252-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39500 LIBERTY STREET",
            "address_2": "TRI CITY HEALTH CENTER",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94538",
            "telephone_number": "510-770-8133",
            "fax_number": "510-770-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHTY",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP13911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Dorsch, ELEMENTARY EDUCATION
• Lyn Marise Dos Santos, MD
• Denise Doscher
• Anisha Ashvanikumar Doshi, PHARMD
• Ankur Ajay Doshi, MD
• James Douglas
• Lora Renee Douglas, RADT
• Madilyn Douglas, OTD, OTR/L
• Raymond Edward Douglas, CADC III
• Doula Solace

• Nurse Practitioner in Fremont, CA
• Providers in Fremont, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.