Individual provider Active NPI

Dan Douer, M.D.

  • Hematology (Internal Medicine) Physician
  • New York, NY
National Provider Identifier
1700825171
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
261841 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-2471
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X A36194 CA
Hematology (Internal Medicine) Physician 207RH0000X 261841 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

633 3Rd Ave
Box 3
New York, NY 10017-6706

Other identifiers 7

IdentifierTypeStateIssuer
GROO16910OtherCAGROUP MEDICAID PIN
W11675OtherCAGROUP MEDICARE PIN
110065232OtherCARAILROAD MEDICARE
1356390009OtherCAGROUP NPI
00A361940OtherCABLUE SHIELD
CE1617OtherCAGROUP RAILROAD MEDICARE
00A361940MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250206003564 CA Order and Referring Only - HematologyPractitioner - Hematology 8921010844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A36194CAMDHematology (Internal Medicine) Physician
261841NYMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Internal Medicine, Inc. 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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1700825171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 3RD AVE",
            "address_2": "BOX 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUER",
        "first_name": "DAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "CA",
            "license": "A36194",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NY",
            "license": "261841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID PIN",
            "identifier": "GROO16910",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "W11675",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110065232",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1356390009",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A361940",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RAILROAD MEDICARE",
            "identifier": "CE1617",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A361940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.