Individual provider Active NPI

John H Doherty Jr., MD

  • Orthopaedic Surgery Physician
  • Scranton, PA
National Provider Identifier
1962488809
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD 023457 E Issued in PA
Practice address
3 W Olive St
Ste 118
Scranton, PA 18508-2572
Phone
(570) 961-3823
Fax
(570) 207-5988
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD 023457 E PA Primary

Addresses

Primary practice location

3 W Olive St
Ste 118
Scranton, PA 18508-2572

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdoherty88479@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20100128000325 PA Practitioner - Orthopedic Surgery 8628037520 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 023457 EPAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jan 1, 2018 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2018 Accepting new patients
Allied Services Institute of Rehabilitation Medicine Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

3 W Olive St
Ste 118
Scranton, PA 18508
Phone (570) 961-3823

475 Morgan Hwy
Scranton, PA 18508
Phone (570) 344-3788

Interoperability endpoints

  • Direct secure messaging: jdoherty88479@direct.geisinger.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1962488809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 W OLIVE ST",
            "address_2": "STE 118",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082572",
            "telephone_number": "570-961-3823",
            "fax_number": "570-207-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD 023457 E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdoherty88479@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3 W Olive St",
            "address_2": "Ste 118",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185082572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.