Ryan Alexander Doherty

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

026682 Issued in NY

Practice address

94 W Main St
Bay Shore, NY 11706-8365

Phone

(631) 983-3724

Fax

(631) 223-4765

NPI assigned

Apr 15, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Rockville Centre, NY
  • NPI 1205296902
  Medicare reassignment Care Compare group NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • New York, NY
  • NPI 1487104972
  NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Randolph, NJ
  • NPI 1104376680
  NPD

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1861135139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 W MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068365",
            "telephone_number": "631-983-3724",
            "fax_number": "631-223-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "RYAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "026682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE OFFICE OF THE PROFESSIONS",
            "identifier": "026682",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DLJ Spectacles
• Jaclynn DO, MD
• Jannika Dodge Khatami, M.D.
• Jonathan Doering
• Mary Doherty, MS ED/SPEC ED CERT
• Brianna Dollard I, LCAT-LP
• Alexandra Dominguez, FNP-BC
• Claudette Marcia Dominique, R.N
• Erin Jane Donohue, MA, LMHC
• Paige G Donohue

• Occupational Therapist in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.