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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

THOMAS MICHAEL DOUGHERTY M.D.
NPI 1699712232
Internal Medicine - Endocrinology, Diabetes & Metabolism in Fullerton, CA

Active since June 01, 2006PECOS Enrolled
1521 S HARBOR BLVD, FULLERTON, CA 92832(714) 990-0911(714) 256-9172 Get Directions Write a Review

NPPES record last updated: July 14, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Thomas Michael Dougherty M.d. NPPES

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

THOMAS MICHAEL DOUGHERTY M.D. (NPI 1699712232) is an individual endocrinology, diabetes & metabolism provider in Fullerton, California, licensed in California (G27977) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Irvine, California College Of Medicine (1973).

NPPES Registry Identity

NPI1699712232
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameTHOMAS MICHAEL DOUGHERTYCredential: M.D.
Location Address1521 S HARBOR BLVDFullerton, CA 92832-3402
Mailing Address1521 S Harbor BlvdFullerton, CA 92832-3402 · (714) 990-0911 · Fax (714) 256-9172
Phone(714) 990-0911
Fax(714) 256-9172
Sole ProprietorYes
Medical School CMSUniversity Of California, Irvine, California College Of MedicineGraduated 1973
Enumeration DateJune 1, 2006
Last NPPES UpdateJuly 14, 2026
NPPES CertifiedJuly 14, 2026
✔ NPI 1699712232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in CA · G27977
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
1521 S HARBOR BLVD, Fullerton, CA 92832
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Other Identifiers 4

Other00G279770Blue Shield Id #
Other023927Health Net Id #
Medicaid00G279770CA
Other110060919Railroad

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

Thomas Michael 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 ID1759392350
PECOS Enrollment IDI20060510000560
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.
128 services60 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92832 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
48%236 patients3/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
86%126 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
90%1,810 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%652 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
1%304 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
73%440 patients4/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
57%443 patients3/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
12%304 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers28 claims28 services$178.88 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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD F. MCGUIRE M.D.
Internal Medicine (Gastroenterology)
1521 S HARBOR BLVD
FULLERTON, CA 92832
Orange County (714) 990-0911
JENNIFER VIRAY NP
Nurse Practitioner
1521 S HARBOR BLVD
FULLERTON, CA 92832
Orange County (562) 417-2921

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 Thomas Dougherty's NPI number?

The NPI number for Thomas Dougherty is 1699712232. It was assigned to this individual provider in the NPPES registry on June 1, 2006.

Where is Thomas Dougherty located?

Thomas Dougherty practices at 1521 S Harbor Blvd, Fullerton, CA 92832. The listed phone number is (714) 990-0911.

What is Thomas Dougherty's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Thomas Dougherty enrolled in Medicare?

Yes. Thomas 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.

When was this NPI record last updated?

The NPPES record for Thomas Dougherty was last updated on July 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 33 days 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.