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DR. PAUL JOSEPH DOUGHERTY M.D.
NPI 1639382328
Orthopaedic Surgery in Detroit, MI

Active since May 08, 2007PECOS EnrolledAccepts Medicare Assignment
81.9/100
CMS Quality Rating
4201 SAINT ANTOINE ST, SUITE 6A, DETROIT, MI 48201(313) 745-4230 Get Directions Write a Review

NPPES record last updated: April 24, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Paul Joseph Dougherty M.d. NPPES

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

DR. PAUL JOSEPH DOUGHERTY M.D. (NPI 1639382328) is an individual orthopaedic surgery provider in Detroit, Michigan, licensed in Michigan (4301083727) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Shands Jacksonville, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1639382328
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. PAUL JOSEPH DOUGHERTYCredential: M.D.
Location Address4201 SAINT ANTOINE ST, SUITE 6ADetroit, MI 48201-2153
Mailing Address4201 Saint Antoine St, Suite 6aDetroit, MI 48201-2153 · (313) 745-4230
Phone(313) 745-4230
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateMay 8, 2007
Last NPPES UpdateApril 24, 2015
✔ NPI 1639382328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in MI · 4301083727
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedOrthopaedic Surgery · Pediatric Orthopaedic SurgeryTaxonomy 207XP3100X · License 4301083727 (MI)
4201 SAINT ANTOINE ST, Detroit, MI 48201
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Other Identifiers 1

Medicare UPING80211MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.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

Dr. Paul Joseph Dougherty 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 ID42288565
PECOS Enrollment IDI20161111001050
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

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
44 services33 patients

Hospital Affiliations CMS Care Compare 2

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

Shands Jacksonville

Acute Care Hospitals · Jacksonville, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100001
Location655 W 8th StJacksonville, FL 32209 · Duval County
Emergency services Birthing friendly

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100088
Location800 Prudential DrJacksonville, FL 32207 · Duval County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48201 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
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.

81.9/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.43
Promoting Interoperability100
Improvement Activities40
Cost59.59

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. ZOHA NIZAMI
Pediatrics (Pediatric Emergency Medicine)
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-5146
DR. PUJA LAROIA DO
Anesthesiology
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-5146
ELIZABETH ANNE RANELLA CRNA
Nurse Anesthetist, Certified Registered
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (952) 442-9770
GERARD LANCASTER MD
Orthopaedic Surgery
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-3000
SARAH ZHANG
Emergency Medicine
4201 SAINT ANTOINE ST, UHC-6G
DETROIT, MI 48201
Wayne County (313) 993-2529
DAVID BURKHOLDER
Student in an Organized Health Care Education/Training Program
4201 SAINT ANTOINE ST, 6G UHC
DETROIT, MI 48201
Wayne County (313) 993-2530
DR. DANIEL RAY CAVAZOS MD
Orthopaedic Surgery
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-3000
WAHAJUDDIN MOHAMMAD DO
Student in an Organized Health Care Education/Training Program
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-5146

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 Paul Dougherty's NPI number?

The NPI number for Paul Dougherty is 1639382328. It was assigned to this individual provider in the NPPES registry on May 8, 2007.

Where is Paul Dougherty located?

Paul Dougherty practices at 4201 Saint Antoine St Suite 6A, Detroit, MI 48201. The listed phone number is (313) 745-4230.

What is Paul Dougherty's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Paul Dougherty enrolled in Medicare?

Yes. Paul Dougherty is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Paul Dougherty accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare list Paul Dougherty as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Paul Dougherty affiliated with any hospitals?

According to CMS data, Paul Dougherty is affiliated with Shands Jacksonville and Baptist Health Medical Center - Jacksonville.

When was this NPI record last updated?

The NPPES record for Paul Dougherty was last updated on April 24, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.