Active NPI
John P Docherty, M.D.
- Psychiatry Physician
- White Plains, NY
National Provider Identifier
1700156403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 111860
- Practice address
- 21 Bloomingdale Rd
White Plains, NY 10605-1504 - Phone
- (914) 843-2541
- NPI assigned
- Jan 11, 2012
- Last updated
- Mar 7, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 111860 | NY | |
| Psychiatry Physician | 2084P0800X | 111860 | NY | Primary |
Addresses
Primary practice location
21 Bloomingdale Rd
White Plains, NY 10605-1504
Mailing address
21 Bloomingdale Rd
White Plains, NY 10605-1504
Phone (914) 843-2541
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111860 | Other | NY | NEW YORK STATE MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 30, 2019 through Mar 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatric Hospital
- White Plains, NY
- NPI 1871639773
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1700156403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 BLOOMINGDALE RD",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106051504",
"telephone_number": "914-843-2541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 BLOOMINGDALE RD",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106051504",
"telephone_number": "914-843-2541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOCHERTY",
"first_name": "JOHN",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-11",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "111860",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "111860",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE MEDICAL LICENSE",
"identifier": "111860",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in White Plains, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.