Individual provider Active NPI

Lauren Marcus Doherty, MD

  • Internal Medicine Physician
  • New London, CT
National Provider Identifier
1306937255
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
044617 Issued in CT
Practice address
365 Montauk Ave
Room 4.512
New London, CT 06320-4700
Phone
(860) 442-0711
Fax
(860) 444-5114
NPI assigned
Sep 27, 2006
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 044617 CT Primary
Hospitalist Physician 208M00000X 044617 CT

Addresses

Primary practice location

365 Montauk Ave
Room 4.512
New London, CT 06320-4700

Mailing address

365 Montauk Ave RM 4.512
New London, CT 06320-4700
Phone (860) 442-0711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061012000415 CT Practitioner - Internal MedicinePractitioner - Hospitalist 0345246427 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
044617CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Northeast, LLC Hospitalist CurrentSince Nov 25, 2024 Accepting new patients
Hospital Medicine Associates LLC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Ma Pacs 2 PC Hospitalist CurrentSince Sep 29, 2020 Accepting new patients
Sound Medical Associates, PC Internal Medicine Past Accepting new patients
Conncare Inc Internal Medicine Past Accepting new patients

Locations

111 Church St
Middletown, CT 06457
Phone (860) 347-3786

31 Vauxhall St
New London, CT 06320
Phone (203) 789-1650

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

365 Montauk Ave
Rm 4
New London, CT 06320

365 Montauk Ave
Rm 4512
New London, CT 06320

88 Clark Ln
Waterford, CT 06385
Phone (860) 442-0471

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beechwood Health & Rehabilitation CenterNew London, CT, CCN 075335 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Mar 1, 2025
May 21, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1306937255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE RM 4.512",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711",
            "fax_number": "860-444-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "address_2": "ROOM 4.512",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711",
            "fax_number": "860-444-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "LAUREN",
        "middle_name": "MARCUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "044617",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "044617",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.