NPIMap

Individual provider Active NPI

Bryan Doherty, M.D.

  • Gastroenterology Physician
  • Silverdale, WA
National Provider Identifier
1497123384
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD61107726 Issued in WA
Practice address
3261 NW Mount Vintage Way Ste 221
Silverdale, WA 98383-6039
Phone
(360) 479-1952
Fax
(360) 479-0318
NPI assigned
Sep 9, 2015
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD61107726 WA Primary

Addresses

Primary practice location

3261 NW Mount Vintage Way Ste 221
Silverdale, WA 98383-6039

Mailing address

3261 NW Mount Vintage Way Ste 221
Silverdale, WA 98383-6039
Phone (360) 479-1952

Other identifiers 1

IdentifierTypeStateIssuer
2179758MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20210527001820 WA Practitioner - Gastroenterology 3870992662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

3261 NW Mount Vintage Way
Suite 221
Silverdale, WA 98383-6039
Phone (360) 792-9118

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy104
Upper gastrointestinal (GI) endoscopy for acid reflux231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61107726WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease & Endoscopy Center, LLC Single Specialty Current Accepting new patients
Digestive Health Consultants, PLLC Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
Washington Gastroenterology PLLC Single Specialty CurrentSince Mar 15, 2023 Accepting new patients
Digestive Disease & Endoscopy Center, LLC Current Accepting new patients
Washington Gastroenterology PLLC CurrentSince Mar 15, 2023 Accepting new patients

Locations

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

1703 S Meridian
Ste 203
Puyallup, WA 98371
Phone (253) 841-3933

1703 S Meridian
Ste 305
Puyallup, WA 98371
Phone (253) 841-3933

3261 NW Mount Vintage Way
Ste 221
Silverdale, WA 98383
Phone (360) 479-1952

3209 S 23rd St
Ste 200
Tacoma, WA 98405
Phone (253) 503-2508

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1497123384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 NW MOUNT VINTAGE WAY STE 221",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983836039",
            "telephone_number": "360-479-1952",
            "fax_number": "360-479-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 NW MOUNT VINTAGE WAY STE 221",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983836039",
            "telephone_number": "360-479-1952",
            "fax_number": "360-479-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "BRYAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD61107726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2179758",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.