Timothy Russell Dougherty Jr., M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

0101261949 Issued in VA

Practice address

4660 Kenmore Ave Ste 100
Alexandria, VA 22304-1306

Phone

(703) 751-5763

Fax

(703) 370-8704

NPI assigned

Jul 17, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Specialty

Gastroenterology

Education

University of Maryland School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gastroenterology Associates of Northern Virginia, LLCGroup PAC ID 1759371008, 98 clinicians

Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040
• Inova Mount Vernon Hospital Hospital, Alexandria, VA, CCN 490122
• Virginia Hospital Center Hospital, Arlington, VA, CCN 490050

Merit-based Incentive Payment System (MIPS)

Final score

92.65 of 100Reported as apm

Quality

85.31

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Gastroenterology Associates of Northern Virginia, LLC

  • Gastroenterology Physician
  • Fairfax, VA
  • NPI 1205884368

  DC

  Medicare reassignment Care Compare group NPD
• Loudoun Medical Group, PC

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Reston, VA
  • NPI 1407908817

  DC

  Medicare reassignment Care Compare group NPD
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment NPD
• Loudoun Medical Group, PC

  • Internal Medicine Physician
  • Leesburg, VA
  • NPI 1679591440
  Medicare reassignment NPD
• Inova Health Care Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD
• Loudoun Medical Group, PC

  • Vascular Surgery Physician
  • Reston, VA
  • NPI 1588376321
  NPD
• Gi Endoscopy Center of Northern Virginia

  • Endoscopy Clinic/Center
  • Alexandria, VA
  • NPI 1790912566
  NPD (past)
• Old Dominion Anesthesia LLC

  • Anesthesiology Physician
  • Charlottesville, VA
  • NPI 1902248677
  NPD (past)

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

• Inova Health Care Services

  • General Acute Care Hospital
  • Alexandria, VA
  • NPI 1255684460
  Care Compare affiliation
• Inova Health Care Services

  • General Acute Care Hospital
  • Alexandria, VA
  • NPI 1922139120
  Care Compare affiliation
• Virginia Hospital Center Arlington Health System

  • General Acute Care Hospital
  • Arlington, VA
  • NPI 1790785996
  Care Compare affiliation

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629232723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 100",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041306",
            "telephone_number": "703-751-5763",
            "fax_number": "703-370-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 100",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041306",
            "telephone_number": "703-751-5763",
            "fax_number": "703-370-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "TIMOTHY",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD039006",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "DC",
            "license": "MD039006",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101261949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annabelle Tupas Dorion, PHARMD
• Erdenemandakh Dorjrenchin, NP
• Goran Dosen, DDS
• Anish Doshi, DDS
• Jose Maria Dossola, MD
• Sarah Elizabeth Douglas, LCSW
• Brian J Douville, LCSW
• Delia Ann Dowd, MSW
• Jennifer Marie Downey, NP
• Robert Lee Doyle III, MT

• Gastroenterology Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Gastroenterology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.