MRS. HEATHER TIFFANY DOUGHERTY MSN RN PMHNP-BC
NPI 1033853114
Nurse Practitioner - Psychiatric/Mental Health in San Diego, CA
About Mrs. Heather Tiffany Dougherty Msn Rn Pmhnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. HEATHER TIFFANY DOUGHERTY MSN RN PMHNP-BC (NPI 1033853114) is an individual psychiatric/mental health provider in San Diego, California, licensed in California (95021374) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Heather Tiffany Dougherty Msn Rn Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Heather Dougherty reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fresno, CA 93710
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Mark David Levine MD Professional Corporation
- 329 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92128
SAN DIEGO, CA 92128
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Heather Dougherty's NPI number?
The NPI number for Heather Dougherty is 1033853114. It was assigned to this individual provider in the NPPES registry on April 25, 2022.
Where is Heather Dougherty located?
Heather Dougherty practices at 11770 Bernardo Plaza Ct Ste 370, San Diego, CA 92128. The listed phone number is (858) 673-3360.
What is Heather Dougherty's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Heather Dougherty enrolled in Medicare?
Yes. Heather Dougherty is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Heather Dougherty's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Heather Dougherty reassigns Medicare benefits to Mark David Levine, MD Fresno (Fresno, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Heather Dougherty's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Heather Dougherty was last updated on July 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Heather Tiffany Dougherty, MSN RN PMHNP-BC · NPI 1033853114
Psychiatric/Mental Health physician in San Diego, California. Individual provider, active in the CMS NPPES registry since April 25, 2022.
## Identity
- **NPI:** 1033853114 (Entity type: Individual)
- **Enumerated:** April 25, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 95021374 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 11770 BERNARDO PLAZA CT STE 370, San Diego, CA 92128-2426
- **Phone:** (858) 673-3360
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mark David Levine, MD Fresno (NPI 1124387097, Fresno, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** July 2, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1033853114) · Data from the CMS NPPES public registry.