JOHN MICHAEL DOUGHTON M.D.
NPI 1043621246
Family Medicine in Rochester, NY

Q: What is John Doughton's NPI number?

The NPI number for John Doughton is 1043621246. It was assigned to this individual provider in the NPPES registry on May 12, 2014.

Q: What is John Doughton's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for John Doughton was last updated on December 13, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 12, 2014PECOS EnrolledAccepts Medicare Assignment

777 CLINTON AVE S, ROCHESTER, NY 14620(585) 279-4800(585) 442-8319 Get Directions Write a Review

NPPES record last updated: December 13, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 13, 2023, Aug 9, 2017, Jul 31, 2017 (3 updates tracked since 2017).

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About John Michael Doughton M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN MICHAEL DOUGHTON M.D. (NPI 1043621246) is an individual family medicine provider in Rochester, New York, licensed in New York (325587) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, is affiliated with Highland Hospital, and is a graduate of University Of Alabama School Of Medicine (2014).

NPPES Registry Identity

NPI1043621246

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJOHN MICHAEL DOUGHTONCredential: M.D.

Location Address777 CLINTON AVE SRochester, NY 14620-1448

Mailing Address777 Clinton Ave SRochester, NY 14620-1448 · (585) 279-4800

Phone(585) 279-4800

Fax(585) 442-8319

Sole ProprietorYes

Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2014

Enumeration DateMay 12, 2014

Last NPPES UpdateDecember 13, 20233 updates tracked since enumeration

NPPES CertifiedDecember 13, 2023

✔ NPI 1043621246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in NY · 325587✔ Licensed in NC · 2017-01176

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

777 CLINTON AVE S, Rochester, NY 14620

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

John Michael Doughton M.d. 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.

PECOS PAC ID4789809443

PECOS Enrollment IDI20170914003064, I20231219003417

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

57 services28 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

33 services15 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

31 services31 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Highland Hospital

Acute Care Hospitals · Rochester, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330164

Location1000 South AvenueRochester, NY 14617 · Monroe County

Emergency services Birthing friendly

Strong Memorial Hospital

Acute Care Hospitals · Rochester, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330285

Location601 Elmwood AveRochester, NY 14642 · Monroe County

Emergency services Birthing friendly

Unc Hospitals

Acute Care Hospitals · Chapel Hill, NC

5/5 CMS rating

OwnershipGovernment - State

CMS Certification Number340061

Location101 Manning DriveChapel Hill, NC 27514 · Orange County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14620 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$16.60 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$83.83 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOPHIA EMMANUELLE HANNA DO

Student in an Organized Health Care Education/Training Program