Miriam Theresa Dougherty, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MA46091 Issued in MA

Practice address

2000 Washington St Ste 206
Newton, MA 02462-1602

Phone

(617) 332-6311

Fax

(617) 243-5650

NPI assigned

Apr 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Ophthalmology

Education

Jefferson Medical College of Thomas Jefferson University, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: dougherty.miriam.mtdmd@direct.partners.masshiway.net

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407073653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 WASHINGTON ST STE 206",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621602",
            "telephone_number": "617-332-6311",
            "fax_number": "617-243-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WASHINGTON ST STE 206",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621602",
            "telephone_number": "617-332-6311",
            "fax_number": "617-243-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MIRIAM",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "MA46091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MA46091",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6173624",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Patricia Dorr, PA-C
• Ana Paula Mendes Dos Santos, BCBA
• Suseela Doss, M.D, FACOG
• Charlotte Elizabeth Dotson
• Aisha Dottin, RE
• Nikki-Taylor Dow
• Dana Catherine Dowd, NP
• Brian Dowling
• John J Dowling, MD
• Amy Lai Doyle, PA-C

• Ophthalmology Physician in Newton, MA
• Providers in Newton, MA by specialty
• Ophthalmology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.