NPIMap

Individual provider Active NPI

Katie Dougherty, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1962433649
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS008476L Issued in PA
Practice address
2534 S 18TH St
Philadelphia, PA 19145-3701
Phone
(215) 463-4363
Fax
(215) 463-4365
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS008476L PA Primary

Addresses

Primary practice location

2534 S 18TH St
Philadelphia, PA 19145-3701

Mailing address

2534 S 18TH St
Philadelphia, PA 19145-3701
Phone (215) 463-4363

Other identifiers 1

IdentifierTypeStateIssuer
01589896MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080616000779 PA Practitioner - Family Practice 8022189257 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1101 Market St
FL 19
Philadelphia, PA 19107-2926

925 Chestnut St
Philadelphia, PA 19107-4204

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

  • Jefferson Health at Home by Bayada Home health agency, Philadelphia, PA, CCN 397643
  • Mercy Home Health Home health agency, Newtown, PA, CCN 397015
  • Residential Home Health of Carlisle LLC Home health agency, Havertown, PA, CCN 397645
  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Jun 7, 2024 Accepting new patients
Methodist Associates in Healthcare, Inc Family Medicine Current Accepting new patients
Methodist Associates in Healthcare, Inc. Family Medicine CurrentSince Jun 7, 2024 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1962433649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 S 18TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453701",
            "telephone_number": "215-463-4363",
            "fax_number": "215-463-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 S 18TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453701",
            "telephone_number": "215-463-4363",
            "fax_number": "215-463-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "KATIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008476L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01589896",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.