DR. TIMOTHY DAUGHERTY M.D.
NPI 1780066738
Surgery - Plastic and Reconstructive Surgery in Springfield, IL

Q: What is Timothy Daugherty's NPI number?

The NPI number for Timothy Daugherty is 1780066738. It was assigned to this individual provider in the NPPES registry on June 26, 2015.

Q: What is Timothy Daugherty's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Daugherty was last updated on January 29, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 26, 2015PECOS EnrolledAccepts Medicare Assignment

747 N RUTLEDGE ST FL 3, SPRINGFIELD, IL 62702(217) 545-8000(217) 545-2588 Get Directions Write a Review

NPPES record last updated: January 29, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Timothy Daugherty M.d. NPPES

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

DR. TIMOTHY DAUGHERTY M.D. (NPI 1780066738) is an individual plastic and reconstructive surgery provider in Springfield, Illinois, licensed in Illinois (036.160543) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and maintains a secondary practice location in Springfield.

NPPES Registry Identity

NPI1780066738

Entity TypeIndividualMale

Primary Taxonomy2086S0122X

Provider Legal NameDR. TIMOTHY DAUGHERTYCredential: M.D.

Location Address747 N RUTLEDGE ST FL 3Springfield, IL 62702-6700

Mailing AddressPo Box 19639Springfield, IL 62794-9639 · (217) 545-8000

Phone(217) 545-8000

Fax(217) 545-2588

Sole ProprietorYes

Medical School CMSSouthern Illinois University School Of MedicineGraduated 2015

Enumeration DateJune 26, 2015

Last NPPES UpdateJanuary 29, 2024

NPPES CertifiedJanuary 29, 2024

✔ NPI 1780066738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0122X

Licenses✔ Licensed in IL · 036.160543✔ Licensed in IL · 125.066594

Definition

A surgeon who specializes in plastic and reconstructive surgery.

747 N RUTLEDGE ST FL 3, Springfield, IL 62702

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Secondary Practice Location 1

Location 1747 N Rutledge St Fl 2Springfield, IL 62702-6700 · Phone (217) 545-8000 · Fax (217) 545-2588

Other Identifiers 1

Medicaid125066594IL

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. Timothy Daugherty 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 ID7113239005

PECOS Enrollment IDI20220823000751

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.

New patient office or other outpatient visit, 30-44 minutes 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

11 services11 patients

Melanoma (skin cancer) excision NAN03

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

0 services11 patients

Mastectomy NAN04

A mastectomy is a surgical procedure that involves the removal of all or part of the breast tissue. This is often done to treat or prevent conditions related to abnormal cell growth. There are different types, ranging from removing only the breast tissue to also removing nearby structures. The approach depends on individual health circumstances.

0 services1 patient

Upper limb (arm) arthroscopy (minimally invasive joint repair) NAN17

Upper limb arthroscopy is a minimally invasive procedure used to examine and treat issues within your arm's joints. A small camera, called an arthroscope, is inserted through a tiny incision, providing a clear view of the joint. This method often results in less pain and faster recovery compared to open surgery.

0 services15 patients

Hospital Affiliations CMS Care Compare 2

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140053

Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County

Emergency services Birthing friendly

Memorial Medical Center

Acute Care Hospitals · Springfield, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140148

Location701 N First StSpringfield, IL 62702 · Sangamon County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 10

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

KYLE J. FIORITO

Occupational Therapist (Hand)