DR. JAMES R DORAN MD
NPI 1942249610
Family Medicine in Higganum, CT
About Dr. James R Doran Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JAMES R DORAN MD (NPI 1942249610) is an individual family medicine provider in Higganum, Connecticut, licensed in Connecticut (51345) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Manchester, and is a graduate of State University Of New York At Buffalo School Of Medicine (2001).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted 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
Dr. James R Doran Md 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.
Medicare Billing Reassignments
4Medicare enrollment records show James Doran reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Wethersfield, CT 06109
- Reassigned Medicare billing, Connecticut enrollment
- 747 clinicians in this Medicare group
Manchester, CT 06040
- Reassigned Medicare billing, Connecticut enrollment
- 422 clinicians in this Medicare group
Farmington, CT 06032
- Reassigned Medicare billing, Connecticut enrollment
- 496 clinicians in this Medicare group
Mansfield Center, CT 06250
- Reassigned Medicare billing, Connecticut enrollment
- 200 clinicians in this Medicare group
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06441 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HIGGANUM, CT 06441
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 James Doran's NPI number?
The NPI number for James Doran is 1942249610. It was assigned to this individual provider in the NPPES registry on June 6, 2006.
Where is James Doran located?
James Doran practices at 415 Killingworth Rd, Higganum, CT 06441. The listed phone number is (860) 345-8535.
What is James Doran's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is James Doran enrolled in Medicare?
Yes. James Doran 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 organizations bill Medicare for James Doran's services?
According to the CMS Revalidation Reassignment List (October 2026 release), James Doran reassigns Medicare benefits to 4 organizations: Hartford Healthcare Medical Group, Inc (Wethersfield, CT), Prospect Ct Medical Foundation, Inc. (Manchester, CT), Prohealth Physicians PC (Farmington, CT) and Natchaug Hospital, Inc. (Mansfield Center, CT). Each 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 James Doran's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does James Doran accept?
Health plans from Anthem Blue Cross and Blue Shield list James Doran 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 James Doran was last updated on December 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.
# Dr. James R Doran, MD · NPI 1942249610
Family Medicine physician in Higganum, Connecticut. Individual provider, active in the CMS NPPES registry since June 6, 2006.
## Identity
- **NPI:** 1942249610 (Entity type: Individual)
- **Enumerated:** June 6, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 51345 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 415 KILLINGWORTH RD, Higganum, CT 06441-4392
- **Phone:** (860) 345-8535 · **Fax:** (860) 345-8678
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Hartford Healthcare Medical Group, Inc (NPI 1043561301, Wethersfield, CT); Prospect Ct Medical Foundation, Inc. (NPI 1144677568, Manchester, CT); Prohealth Physicians PC (NPI 1720194053, Farmington, CT); Natchaug Hospital, Inc. (NPI 1295811321, Mansfield Center, CT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** State University Of New York At Buffalo School Of Medicine, class of 2001
## Record status
- **NPPES last updated:** December 12, 2025
- **Other identifiers:** Medicaid 03704381 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1942249610) · Data from the CMS NPPES public registry.