DR. JACOB RANDALL DOUGHERTY DPM
NPI 1326577859
Podiatrist - Foot & Ankle Surgery in Cleveland, OH

Q: What is Jacob Dougherty's NPI number?

The NPI number for Jacob Dougherty is 1326577859. It was assigned to this individual provider in the NPPES registry on June 8, 2017.

Q: What is Jacob Dougherty's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Dougherty was last updated on July 21, 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.

Active since June 08, 2017PECOS Enrolled

10701 EAST BLVD, CLEVELAND, OH 44106(216) 791-3800(216) 421-3038 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2022, May 21, 2020, Jun 8, 2017 (3 updates tracked since 2017).

On this page

About Dr. Jacob Randall Dougherty Dpm NPPES

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

DR. JACOB RANDALL DOUGHERTY DPM (NPI 1326577859) is an individual foot & ankle surgery provider in Cleveland, Ohio, licensed in Florida (PO4179) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1326577859

Entity TypeIndividualMale

Primary Taxonomy213ES0103X

Provider Legal NameDR. JACOB RANDALL DOUGHERTYCredential: DPM

Location Address10701 EAST BLVDCleveland, OH 44106-1702

Mailing Address730 Goodlette Rd N, Ste 102Naples, FL 34102-5617 · (239) 430-3668 · Fax (239) 692-9436

Phone(216) 791-3800

Fax(216) 421-3038

Sole ProprietorNo

Enumeration DateJune 8, 2017

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

NPPES CertifiedMay 21, 2020

✔ NPI 1326577859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

License✔ Licensed in FL · PO4179

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

10701 EAST BLVD, Cleveland, OH 44106

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacob Randall Dougherty Dpm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Jacob Dougherty reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Christus Trinity Clinic Texas

984 mi

Family Medicine

520 DOUGLAS BLVD
Tyler, TX 75702

Reassigned Medicare billing, Texas enrollment
2,745 clinicians in this Medicare group

NPI 1285684225 (903) 315-4119

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Referred Medical Equipment & Supplies CMS DME claims

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

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361

DME-Orthotic Devices · category DF003N

2 suppliers23 claims23 services$207.12 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.

MRS. RACHEL MICHELLE HERNANDEZ R.N.

Registered Nurse

10701 EAST BLVD
CLEVELAND, OH 44106

Cuyahoga County (216) 791-3800

MATTHEW BENICK

Recreation Therapist

10701 EAST BLVD, 5M-690E EUL
CLEVELAND, OH 44106

Cuyahoga County (216) 791-3800

RONALD LEE DENNEY JR. CNP

Nurse Practitioner (Primary Care)

10701 EAST BLVD
CLEVELAND, OH 44106

Cuyahoga County (216) 791-3800

ANTHONY ROSSO MBA, RRT

Respiratory Therapist, Registered

10701 EAST BLVD
CLEVELAND, OH 44106

Cuyahoga County (216) 791-3800

SARA ELIZABETH LYNCH RN

Registered Nurse (Emergency)

10701 EAST BLVD
CLEVELAND, OH 44106

Cuyahoga County (216) 791-3800

ZOE ROBERS

Student in an Organized Health Care Education/Training Program

10701 EAST BLVD
CLEVELAND, OH 44106

Cuyahoga County (216) 791-3800

DR. SUSAN KIRSH MD

Internal Medicine

10701 EAST BLVD
CLEVELAND, OH 44106

Cuyahoga County (216) 701-0519

DEBORAH KELLER-CATANIA NP

Nurse Practitioner (Adult Health)

10701 EAST BLVD, (W)111
CLEVELAND, OH 44106

Cuyahoga County (216) 791-3800

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 Jacob Dougherty's NPI number?

The NPI number for Jacob Dougherty is 1326577859. It was assigned to this individual provider in the NPPES registry on June 8, 2017.

Where is Jacob Dougherty located?

Jacob Dougherty practices at 10701 East Blvd, Cleveland, OH 44106. The listed phone number is (216) 791-3800.

What is Jacob Dougherty's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Jacob Dougherty enrolled in Medicare?

Yes. Jacob Dougherty is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacob Dougherty's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Dougherty reassigns Medicare benefits to Christus Trinity Clinic Texas (Tyler, TX). 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 Jacob 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 Jacob Dougherty was last updated on July 21, 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.