1. Home
  2. Directory
  3. Indiana
  4. Munster
  5. Specialist Technologist
  6. NPI Profile

MICHAEL JOHN DOHERTY ATC, LAT, DPT
NPI 1730616574
Specialist/Technologist - Athletic Trainer in Munster, IN

Active since May 11, 2017Accepts Medicare Assignment
10133 DEVONSHIRE LN, MUNSTER, IN 46321(219) 381-1861 Get Directions Write a Review

NPPES record last updated: May 11, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Michael John Doherty Atc, Lat, Dpt NPPES

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

MICHAEL JOHN DOHERTY ATC, LAT, DPT (NPI 1730616574) is an individual athletic trainer provider in Munster, Indiana, licensed in Indiana (36002268A) and active in the NPI registry since May 2017. He is a graduate of Other (2017).

NPPES Registry Identity

NPI1730616574
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameMICHAEL JOHN DOHERTYCredential: ATC, LAT, DPT
Location Address10133 DEVONSHIRE LNMunster, IN 46321-4376
Mailing Address10133 Devonshire LnMunster, IN 46321-4376
Phone(219) 381-1861
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateMay 11, 2017
✔ NPI 1730616574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License✔ Licensed in IN · 36002268A
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
10133 DEVONSHIRE LN, Munster, IN 46321
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael John Doherty Atc, Lat, Dpt 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 ID9638443559
PECOS Enrollment IDI20240124002050

Medicare Billing Reassignment

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

Bentonville Physical Therapy Specialists
508 mi
Orthopedic
907 SE VILLAGE LOOP STE 5
Bentonville, AR 72712
  • Reassigned Medicare billing, Arkansas enrollment
  • 2 clinicians in this Medicare group
NPI 1437696440 (479) 268-6040

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

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 Michael Doherty's NPI number?

The NPI number for Michael Doherty is 1730616574. It was assigned to this individual provider in the NPPES registry on May 11, 2017.

Where is Michael Doherty located?

Michael Doherty practices at 10133 Devonshire Ln, Munster, IN 46321. The listed phone number is (219) 381-1861.

What is Michael Doherty's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Is Michael Doherty enrolled in Medicare?

Yes. Michael Doherty 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.

Which organization bills Medicare for Michael Doherty's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Doherty reassigns Medicare benefits to Bentonville Physical Therapy Specialists (Bentonville, AR). 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 Michael Doherty's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Doherty accept?

Health plans from Health Advantage and Octave list Michael Doherty 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.

When was this NPI record last updated?

The NPPES record for Michael Doherty was last updated on May 11, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.