KELLY ALICE DRIVDAHL DOUGHERTY MD
NPI 1336709096
Emergency Medicine in Philadelphia, PA

Q: What is Kelly Dougherty's NPI number?

The NPI number for Kelly Dougherty is 1336709096. It was assigned to this individual provider in the NPPES registry on June 15, 2019.

Q: What is Kelly Dougherty's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Dougherty was last updated on May 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 15, 2019PECOS Enrolled

84.47/100

CMS Quality Rating

3401 N BROAD ST, PHILADELPHIA, PA 19140(215) 707-5435 Get Directions Write a Review

NPPES record last updated: May 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 1, 2023, Jun 20, 2019, Jun 15, 2019 (3 updates tracked since 2019).

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About Kelly Alice Drivdahl Dougherty Md NPPES

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

KELLY ALICE DRIVDAHL DOUGHERTY MD (NPI 1336709096) is an individual emergency medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MT218870) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336709096

Entity TypeIndividualFemale

Primary Taxonomy207P00000X

Provider Legal NameKELLY ALICE DRIVDAHL DOUGHERTYCredential: MD

Location Address3401 N BROAD STPhiladelphia, PA 19140-5189

Mailing Address1620 Mount Vernon St Apt 3Philadelphia, PA 19130-3320 · (484) 350-2351

Phone(215) 707-5435

Sole ProprietorNo

Enumeration DateJune 15, 2019

Last NPPES UpdateMay 1, 20233 updates tracked since enumeration

NPPES CertifiedMay 1, 2023

✔ NPI 1336709096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in PA · MT218870

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

3401 N BROAD ST, Philadelphia, PA 19140

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Alice Drivdahl Dougherty Md 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.

Areas of Expertise CMS Part B claims 4

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.

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

83 services83 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

65 services65 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

22 services22 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19140 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.47/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

93.33

Promoting Interoperability

100

Improvement Activities

Cost

54.91

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.

DR. JAMIE L. GARFIELD MD

Internal Medicine