Active NPI
Alexander Daniel Doudt, D.O.
- Urology Physician
- Portsmouth, VA
National Provider Identifier
1780094896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 14295
- Practice address
- 620 John Paul Jones Cir
Portsmouth, VA 23708-2111 - Phone
- (757) 953-5000
- NPI assigned
- Apr 29, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 310673-01 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Urology Physician | 208800000X | 14295 | CA | Primary |
Addresses
Primary practice location
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Mailing address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (757) 953-5000
Other practice location 1
1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230912000995 | NY | Order and Referring Only - Urology | 9638556137 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14295 | CA | MD | Urology Physician |
| 310673-01 | NY | MD | Urology Physician |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678492800000",
"number": "1780094896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-5000"
}
],
"practiceLocations": [
{
"address_1": "1275 York Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100656007",
"country_code": "US",
"telephone_number": "212-639-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOUDT",
"first_name": "ALEXANDER",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-29",
"last_updated": "2023-03-11",
"certification_date": "2023-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "310673-01",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "14295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.