Active NPI
Melissa J Doherty, M.D.
- Emergency Medicine Physician
- Eugene, OR
National Provider Identifier
1629017355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD24499
- Practice address
- 1255 Hilyard St
Eugene, OR 97401-3718 - Phone
- (503) 686-7300
- NPI assigned
- Jun 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD24499 | OR | Primary |
Addresses
Primary practice location
1255 Hilyard St
Eugene, OR 97401-3718
Mailing address
PO Box 4078
Portland, OR 97208-4078
Phone (888) 633-0086
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227514 | Medicaid | OR | |
| 8939235 | Other | WASHINGTON CRIME VICTIMS | |
| H73744 | Other | LIPA | |
| XPY199702 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary'S Peak Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Corvallis, OR
- NPI 1194733360
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196640000000",
"number": "1629017355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4078",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084078",
"telephone_number": "888-633-0086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 HILYARD ST",
"city": "EUGENE",
"state": "OR",
"postal_code": "974013718",
"telephone_number": "503-686-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOHERTY",
"first_name": "MELISSA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2007-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OR",
"license": "MD24499",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227514",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON CRIME VICTIMS",
"identifier": "8939235",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIPA",
"identifier": "H73744",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "XPY199702",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.