Active NPI
Kenneth Geoffrey Doughlin, M.D.
- Surgery Physician
- Jamaica, NY
National Provider Identifier
1669495339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 143396
- Practice address
- 8900 Van Wyck Expy
Jamaica Hospital Medical Center
Jamaica, NY 11418-2897 - Phone
- (718) 206-6070
- Fax
- (718) 206-6085
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 143396 | NY | Primary |
Addresses
Primary practice location
8900 Van Wyck Expy
Jamaica Hospital Medical Center
Jamaica, NY 11418-2897
Mailing address
8900 Van Wyck Expy
Jamaica Hospital Medical Center
Jamaica, NY 11418-2897
Phone (718) 206-6070
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 143396 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TJH Medical Services, P.C. | Surgery | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669495339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8900 VAN WYCK EXPY",
"address_2": "JAMAICA HOSPITAL MEDICAL CENTER",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114182897",
"telephone_number": "718-206-6070",
"fax_number": "718-206-6085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8900 VAN WYCK EXPY",
"address_2": "JAMAICA HOSPITAL MEDICAL CENTER",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114182897",
"telephone_number": "718-206-6070",
"fax_number": "718-206-6085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGHLIN",
"first_name": "KENNETH",
"middle_name": "GEOFFREY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "143396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.