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

CONNOR PATRICK DOHERTY PA-C, ATC
NPI 1831735851
Physician Assistant in Indianapolis, IN

Q: What is Connor Doherty's NPI number?

The NPI number for Connor Doherty is 1831735851. It was assigned to this individual provider in the NPPES registry on November 25, 2019.

Q: What is Connor Doherty's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Connor Doherty was last updated on July 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 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.

Active since November 25, 2019PECOS EnrolledAccepts Medicare Assignment

3400 LAFAYETTE RD STE 200, INDIANAPOLIS, IN 46222(317) 291-7422(317) 291-7433 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 3, 2026, Jun 13, 2025, Aug 6, 2024 and 1 more (4 updates tracked since 2019).

On this page

About Connor Patrick Doherty Pa-c, Atc NPPES

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

CONNOR PATRICK DOHERTY PA-C, ATC (NPI 1831735851) is an individual physician assistant in Indianapolis, Indiana, licensed in Indiana (10004557A) and active in the NPI registry since November 2019. He is enrolled in Medicare PECOS, is affiliated with Indiana University Health Ball Memorial Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1831735851

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameCONNOR PATRICK DOHERTYCredential: PA-C, ATC

Location Address3400 LAFAYETTE RD STE 200Indianapolis, IN 46222-1147

Mailing Address3400 Lafayette Rd Ste 200Indianapolis, IN 46222-1147 · (317) 291-7422 · Fax (317) 291-7433

Phone(317) 291-7422

Fax(317) 291-7433

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateNovember 25, 2019

Last NPPES UpdateJuly 1, 20264 updates tracked since enumeration

NPPES CertifiedJuly 1, 2026

✔ NPI 1831735851 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IN · 10004557A

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X · License 096004117 (IL)

3400 LAFAYETTE RD STE 200, Indianapolis, IN 46222

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Secondary Practice Locations 2

Location 1333 S Madison StMuncie, IN 47305-2465 · Phone (765) 287-3087

Location 25750 W 56th StIndianapolis, IN 46254-1695 · Phone (317) 291-7422 · Fax (317) 291-7433

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Connor Patrick Doherty Pa-c, Atc 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 ID7810421088

PECOS Enrollment IDI20241111001269

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.

Hospital Affiliations CMS Care Compare

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

Indiana University Health Ball Memorial Hospital

Acute Care Hospitals · Muncie, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150089

Location2401 University AveMuncie, IN 47303 · Delaware County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46222 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

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.

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.

AMANDA R POWERS NP

Nurse Practitioner