JENNIFER LYNN DOUGHERTY
NPI 1265629968
Physician Assistant - Medical in Lancaster, PA

NPI Status: Active since September 27, 2007

Contact Information

540 N DUKE ST
LANCASTER, PA
ZIP 17602
Phone: (717) 544-4930
Fax: (717) 544-4964

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  • Individual
  • Female
  • Years of Experience 19
  • Physician Assistant
  • Medical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JENNIFER DOUGHERTY

This page provides the complete NPI Profile along with additional information for Jennifer Dougherty, a primary care provider established in Lancaster, Pennsylvania with a medical specialization in Physician Assistant, focusing in medical and more than 19 years of experience. The healthcare provider is registered in the NPI registry with number 1265629968 assigned on September 2007. The practitioner's primary taxonomy code is 363AM0700X with license number MA053172 (PA). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1265629968
Provider Name
JENNIFER LYNN DOUGHERTY
Other Name
JENNIFER LYNN GRIGLIONE
Other Name Type
Former Name (1)
Gender
Female
Entity Type
Individual
Location Address
540 N DUKE ST LANCASTER, PA 17602
Location Phone
(717) 544-4930
Location Fax
(717) 544-4964
Mailing Address
540 N DUKE ST LANCASTER, PA 17602
Mailing Phone
(717) 544-4930
Mailing Fax
(717) 544-4964
Medical School Name
OTHER
Graduation Year
2007
Is Sole Proprietor?
No
Enumeration Date
09-27-2007
Last Update Date
03-15-2024
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A primary care provider (PCP) like Jennifer Dougherty sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
MA053172
License State
PA

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Principal Bronze HSA - EPO
  • Principal Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Jennifer Dougherty is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jennifer Dougherty is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 941398234

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20071231000055

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    22 DME suppliers used 512 Medicare Claims 512 Services Paid

  • DME-Other DME (DE000N)

    Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)

    3 DME suppliers used 23 Medicare Claims 43 Services Paid

  • DME-Other DME (DE000N)

    Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable (HCPCS:A7005)

    4 DME suppliers used 18 Medicare Claims 18 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    22 DME suppliers used 482 Medicare Claims 484 Services Paid

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    21 DME suppliers used 512 Medicare Claims 1291 Services Paid

  • DME-Other DME (DE001N)

    Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

    17 DME suppliers used 502 Medicare Claims 2688 Services Paid

  • DME-Other DME (DE001N)

    Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)

    14 DME suppliers used 308 Medicare Claims 1637 Services Paid

  • DME-Other DME (DE001N)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    18 DME suppliers used 782 Medicare Claims 785 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    28 DME suppliers used 730 Medicare Claims 731 Services Paid

  • DME-Other DME (DE001N)

    Chinstrap used with positive airway pressure device (HCPCS:A7036)

    12 DME suppliers used 77 Medicare Claims 77 Services Paid

  • DME-Other DME (DE001N)

    Tubing used with positive airway pressure device (HCPCS:A7037)

    15 DME suppliers used 653 Medicare Claims 657 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    29 DME suppliers used 1289 Medicare Claims 6698 Services Paid

  • DME-Other DME (DE001N)

    Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)

    19 DME suppliers used 239 Medicare Claims 239 Services Paid

  • DME-Other DME (DE001N)

    Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

    22 DME suppliers used 552 Medicare Claims 552 Services Paid

  • DME-Oxygen and Supplies (DC000N)

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

    4 DME suppliers used 150 Medicare Claims 157 Services Paid

  • DME-Other DME (DE005N)

    Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)

    1 DME suppliers used 97 Medicare Claims 97 Services Paid

  • DME-Other DME (DE001N)

    Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0470)

    7 DME suppliers used 90 Medicare Claims 93 Services Paid

  • DME-Other DME (DE001N)

    Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

    8 DME suppliers used 26 Medicare Claims 26 Services Paid

  • DME-Other DME (DE001N)

    Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

    6 DME suppliers used 798 Medicare Claims 860 Services Paid

  • DME-Other DME (DE000N)

    Nebulizer, with compressor (HCPCS:E0570)

    7 DME suppliers used 82 Medicare Claims 103 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    16 DME suppliers used 1037 Medicare Claims 1067 Services Paid

  • DME-Oxygen and Supplies (DC002N)

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

    7 DME suppliers used 327 Medicare Claims 333 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    4 DME suppliers used 44 Medicare Claims 44 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:K0738)

    2 DME suppliers used 31 Medicare Claims 31 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    35 DME suppliers used 177 Medicare Claims 177 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 90 days (HCPCS:Q0514)

    9 DME suppliers used 17 Medicare Claims 17 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms (HCPCS:J7605)

    5 DME suppliers used 14 Medicare Claims 960 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms (HCPCS:J7606)

    2 DME suppliers used 21 Medicare Claims 1260 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

    19 DME suppliers used 62 Medicare Claims 16026 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

    20 DME suppliers used 82 Medicare Claims 9152 Services Paid

  • DME-Drugs Administered Through DME (DG000N)

    Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)

    23 DME suppliers used 108 Medicare Claims 8222 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram (HCPCS:J7677)

    3 DME suppliers used 17 Medicare Claims 89250 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 615 times for 458 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 57 times for 54 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 106 times for 106 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jennifer Dougherty is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
LANCASTER GENERAL HOSPITAL555 NORTH DUKE STREET
LANCASTER, PA 17602
(717) 544-5511Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1265629968, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
5
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
9
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 6 → 12 → 3 9 → 18 → 9 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 2 + 5 + 1 + 2 + 2 + 1 + 8 + 9 + 1 + 2 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1265629968.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Family Medicine
540 N DUKE ST, 3RD FLOOR
LANCASTER, PA 17602
Family Medicine
540 N DUKE ST, 3RD FLOOR
LANCASTER, PA 17602
Family Medicine
540 N DUKE ST
LANCASTER, PA 17602
Psychologist
540 N DUKE ST, 3RD FLOOR
LANCASTER, PA 17602
Family Medicine
540 N DUKE ST, 3RD FLOOR
LANCASTER, PA 17602
Physician Assistant (Surgical)
540 N DUKE ST, SUITE 110
LANCASTER, PA 17602
Family Medicine
540 N DUKE ST, 3RD FLOOR
LANCASTER, PA 17602
Family Medicine
540 N DUKE ST, 3RD FLOOR
LANCASTER, PA 17602
Nurse Practitioner
540 N DUKE ST, 3RD FLOOR
LANCASTER, PA 17602
Physician Assistant (Medical)
540 N DUKE ST
LANCASTER, PA 17602
Physician Assistant (Surgical)
540 N DUKE ST, SUITE 110
LANCASTER, PA 17602
Internal Medicine (Pulmonary Disease)
540 N DUKE ST, SUITE 244
LANCASTER, PA 17602
Physician Assistant (Surgical)
540 N DUKE ST, SUITE 110
LANCASTER, PA 17602
Family Medicine
540 N DUKE ST, 3RD FLOOR
LANCASTER, PA 17602
Physician Assistant (Medical)
540 N DUKE ST
LANCASTER, PA 17602
Thoracic Surgery (Cardiothoracic Vascular Surgery)
540 N DUKE ST, SUITE 110
LANCASTER, PA 17602
Physician Assistant
540 N DUKE ST
LANCASTER, PA 17602
Nurse Practitioner (Family)
540 N DUKE ST
LANCASTER, PA 17602
Nurse Practitioner (Family)
540 N DUKE ST, SUITE 110
LANCASTER, PA 17602
Physician Assistant (Medical)
540 N DUKE ST
LANCASTER, PA 17602

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265629968, enumerated as an "individual" on September 27, 2007.

The provider is located at 540 N DUKE ST LANCASTER, PA 17602 and the phone number is (717) 544-4930.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter Health. Please consult your insurance carrier or call the provider to verify.

Jennifer Dougherty is affiliated with: LANCASTER GENERAL HOSPITAL.