Laura Desiree Dougherty, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA19988 Issued in CA

Practice address

9775 SE Sunnyside Rd Ste 500
Clackamas, OR 97015-5724

Phone

(503) 654-7546

Fax

(503) 786-3542

NPI assigned

Feb 28, 2006

Last updated

Nov 17, 2022By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clackamas Dermatology PCGroup PAC ID 4183618440, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Portland Hospital, Portland, OR, CCN 380060

Merit-based Incentive Payment System (MIPS)

Final score

99.11 of 100Reported as apm

Quality

84.29

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Clackamas Dermatology PC

  dba Goodskin Dermatology

  • Dermatology Physician
  • Clackamas, OR
  • NPI 1700221397
  Medicare reassignment Care Compare group
• Allergy Asthma & Dermatology Associates PC

  dba Allergy Associates, PC

  • Dermatology Physician
  • Portland, OR
  • NPI 1801849849
  NPD (past)
• Medical Associates of Pinellas LLC

  • Nurse Practitioner
  • Dunedin, FL
  • NPI 1619976834
  NPD (past)
• Suncoast Medical Clinic LLC

  • Clinical Medical Laboratory
  • St Petersburg, FL
  • NPI 1649397662
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Portland Adventist Medical Center

  dba Adventist Health Portland

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1801887658
  Care Compare affiliation

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1316913387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9775 SE SUNNYSIDE RD STE 500",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155724",
            "telephone_number": "503-654-7546",
            "fax_number": "503-786-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9775 SE SUNNYSIDE RD STE 500",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155724",
            "telephone_number": "503-654-7546",
            "fax_number": "503-786-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "LAURA",
        "middle_name": "DESIREE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "PA19988",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khoa Doan Doan, PHARMD
• Donald G. Dodson, PH.D.
• Martin T Donohoe, M.D.
• Jeffrey Roel Dougal, D.C., L.M.T.
• Jean Elizabeth Dougherty, CRNA
• Kristen Marie Douglass, MD
• Mark William Douglass, LPC
• Cameron Jon Dow
• Dylan Dow, LCSW
• Valerie Anne Downey, M.D.

• Medical Physician Assistant in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.