Douglas Andrew Dougherty, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

192176 Issued in NY

Practice address

1000 Franklin Ave Ste 100
Garden City, NY 11530-2910

Phone

(516) 248-8334

Fax

(516) 248-1357

NPI assigned

Jun 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY, Pediatrics

  Medicare reassignment NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD
• Long Island Primary Medical Care/Dba Village Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Garden City, NY
  • NPI 1316992886
  NPD (past)

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1962406538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 FRANKLIN AVE STE 100",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302910",
            "telephone_number": "516-248-8334",
            "fax_number": "516-248-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 FRANKLIN AVE STE 100",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302910",
            "telephone_number": "516-248-8334",
            "fax_number": "516-248-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "DOUGLAS",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "192176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01488059",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddougherty222111@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "1000 Franklin Ave Ste 100",
            "city": "Garden City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115302910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol Donofrio, LCSW
• Daniel S Donohue, MD
• Catia I Dores, LMHC
• Cherie Y Dortch, LCSW
• Sima Doshi-Carnevale, MD
• Barry K Douglas, M.D.
• Joseph Doukas
• Casandra Dove
• Connor A Dove
• Jane Ann Dowling

• Pediatrics Physician in Garden City, NY
• Providers in Garden City, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.