MAX LOGAN DOUGHERTY MD, PHD
NPI 1164051637
Internal Medicine - Hematology in New York, NY
About Max Logan Dougherty Md, Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAX LOGAN DOUGHERTY MD, PHD (NPI 1164051637) is an individual hematology provider in New York, New York, licensed in New York (320619) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in New York, and is a graduate of University Of Washington School Of Medicine (2021).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Max Logan Dougherty Md, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Max Dougherty reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New York, NY 10029
- Reassigned Medicare billing, New York enrollment
- 275 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 10029 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Max Dougherty's NPI number?
The NPI number for Max Dougherty is 1164051637. It was assigned to this individual provider in the NPPES registry on April 6, 2020.
Where is Max Dougherty located?
Max Dougherty practices at 1470 Madison Ave, New York, NY 10029. The listed phone number is (212) 241-6756.
What is Max Dougherty's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.
Is Max Dougherty enrolled in Medicare?
Yes. Max Dougherty is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Max Dougherty's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Max Dougherty reassigns Medicare benefits to Icahn School Of Medicine At Mount Sinai (New York, NY). 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 Max 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 Max Dougherty was last updated on May 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.
# Max Logan Dougherty, MD, PHD · NPI 1164051637
Hematology physician in New York, New York. Individual provider, active in the CMS NPPES registry since April 6, 2020.
## Identity
- **NPI:** 1164051637 (Entity type: Individual)
- **Enumerated:** April 6, 2020
- **Primary specialty:** Internal Medicine - Hematology · taxonomy 207RH0000X
- **State license:** 320619 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1470 MADISON AVE, New York, NY 10029-6542
- **Phone:** (212) 241-6756
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Icahn School Of Medicine At Mount Sinai (NPI 1750649612, New York, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Washington School Of Medicine, class of 2021
## Record status
- **NPPES last updated:** May 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1164051637) · Data from the CMS NPPES public registry.