NPIMap

Individual provider Active NPI

Charles O Dougherty, MD

  • Family Medicine Physician
  • Yardley, PA
National Provider Identifier
1376572792
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD420232 Issued in PA
Practice address
62 South Main Street
Yardley, PA 19067
Phone
(215) 493-5535
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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 MD420232 PA Primary

Addresses

Primary practice location

62 South Main Street
Yardley, PA 19067

Mailing address

62 South Main Street
Yardley, PA 19067

Other identifiers 1

IdentifierTypeStateIssuer
0019534830001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110121000572 PA Practitioner - Family Practice 0840479986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinical Care Associates of the University of Pennsylvania Health. 591 clinicians

Practice addresses (Care Compare)

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Newtown, PA, CCN 397015
  • Penn Medicine Home Health Home health agency, Bala Cynwyd, PA, CCN 397125
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010
  • St Mary Medical Center Hospital, Langhorne, PA, CCN 390258
  • Doylestown Hospital Hospital, Doylestown, PA, CCN 390203
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine CurrentSince Jul 1, 2003 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2003 Accepting new patients
Penncare Bucks County - Family Medicine Past Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Past Accepting new patients

Locations

1338 Bristol Pike
Ste B
Bensalem, PA 19020

777 Township Line Rd
Yardley, PA 19067
Phone (215) 399-6011

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

62 S Main St
Yardley, PA 19067
Phone (215) 493-5535

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1376572792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 SOUTH MAIN STREET",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "19067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 SOUTH MAIN STREET",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "19067",
            "telephone_number": "215-493-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "CHARLES",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD420232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019534830001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yardley, PA

Sources for this page

Verify at the official NPI Registry.