Michael Sean Doherty, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5171 S Cottonwood St Ste 740
Murray, UT 84107-5705

Phone

(801) 507-9700

Fax

(801) 507-9705

NPI assigned

Jan 19, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT, CA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshall Medical Center Hospital, Placerville, CA, CCN 050254

Merit-based Incentive Payment System (MIPS)

Final score

99.12 of 100Reported as group

Quality

94.64

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdoherty446140@direct.med.utah.edu

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.

• Marshall Medical Center

  • Family Medicine Physician
  • El Dorado Hills, CA
  • NPI 1114727377
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment
• Utah Emergency Physicians

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1588048979
  Medicare reassignment
• Emergency Medicine Physician Partners of El Dorado County, Inc

  • Emergency Medicine Physician
  • Placerville, CA
  • NPI 1619278660
  Medicare reassignment
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Logan, UT
  • NPI 1710996673
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• University of Utah Adult Services

  • Geriatric Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
  • NPI 1407250202
  NPD
• Marshall Medical Center

  • Orthopaedic Surgery Physician
  • Placerville, CA
  • NPI 1649562315
  NPD

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

• Marshall Medical Center

  • General Acute Care Hospital
  • Placerville, CA
  • NPI 1972503142
  Care Compare affiliation

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1609313360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 S COTTONWOOD ST STE 740",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075705",
            "telephone_number": "801-507-9700",
            "fax_number": "801-507-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 S COTTONWOOD ST STE 740",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075705",
            "telephone_number": "801-507-9700",
            "fax_number": "801-507-9705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4940 Eastern Ave",
            "address_2": "Suite A-150",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212242735",
            "country_code": "US",
            "telephone_number": "410-550-0360",
            "fax_number": "410-550-0178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "MICHAEL",
        "middle_name": "SEAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-19",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdoherty446140@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• DJC Spine Interventions
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• Jeffrey Scott Dodd, PTA
• David William Dodds, M.D.
• Mark Whitney Dodson, MD, PHD
• Donorconnect
• Kathy Monica Doom
• Kristienna M Doro, FNP
• John Richard Doty, MD
• Cherish Douglas

• Physician Assistant in Murray, UT
• Providers in Murray, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.