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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 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: November 01, 2026.

On this page

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

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

Siu Physicians & Surgeons, Inc

0.3 mi

Endocrinology, Diabetes & Metabolism

201 E MADISON ST STE 328
Springfield, IL 62702

Reassigned Medicare billing, Illinois enrollment
645 clinicians in this Medicare group

NPI 1558385989 (217) 545-8000

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

Areas of Expertise CMS Part B claims 7

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

100 services17 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

69 services37 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

20 services16 patients

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.

19 services16 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

17 services15 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 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.

16 services16 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 14

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

DR. AUSTIN MICHAEL BEASON MD

Orthopaedic Surgery