Jamie Dougherty

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

013831-1 Issued in NY

Practice address

2619 Culver Rd
Suite 2a
Rochester, NY 14609-1738

Phone

(585) 342-2410

Fax

(585) 342-9141

NPI assigned

Mar 5, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Rochester General Hospital

  dba Rochester General Medical Groups

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712
  Medicare reassignment NPD
• St James Hospital

  • Rural Acute Care Hospital
  • Hornell, NY
  • NPI 1013985399
  Medicare reassignment
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1063531929
  NPD (past)
• St Joseph's Hospital and Health Center

  dba CHI St Alexius Health Dickinson Medical Clinic

  • Clinic/Center
  • Dickinson, ND
  • NPI 1730464108
  NPD (past)
• St Joseph's Hospital and Health Center

  dba CHI St Alexius Health Dickinson

  • Critical Access Hospital
  • Dickinson, ND
  • NPI 1992947956
  NPD (past)

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1932422920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 CULVER RD",
            "address_2": "SUITE 2A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146091738",
            "telephone_number": "585-342-2410",
            "fax_number": "585-342-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 CULVER RD",
            "address_2": "SUITE 2A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146091738",
            "telephone_number": "585-342-2410",
            "fax_number": "585-342-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "JAMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "013831-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric D Dotson, M.D.
• Shareese Adrienne Dotson
• Christopher Doucette
• Karen Victoria Doucette, LMT
• Angela Catherine Dougherty, NP
• Kevin Michael Dougherty, REGISTERED NURSE
• Mary Dougherty, OTR/L
• Matthew Cooney Dougherty
• Monica Dougherty, PHARMD
• Paul Edward Dougherty, D.C.

• Surgical Physician Assistant in Rochester, NY
• Providers in Rochester, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.

Verify at the official NPI Registry.