SUSAN L DOUGHTY (NP) – Nurse Practitioner, NPI 1285676759

SUSAN L DOUGHTY (NP) is a healthcare provider. based in Fremont, California. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. NP13911 (CA). The NPI Number for SUSAN L DOUGHTY (NP) is 1285676759

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
SUSAN L DOUGHTY (NP)
NPI
1285676759
Phone
(510) 252-5897
Address
39500 LIBERTY STREET
Enumeration Date
11 June 2006
Last Update Date
2 August 2012

Doctor Profile

Medical School Name
COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Secondary Phone
5107708040
Graduation Year
1996 (30 years ago)
PAC ID
1052442514
Group Practice PAC ID
1658349824
Professional Enrollment ID
I20100626000505
Address ID
CA945381738FR1999XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

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Provider Addresses for SUSAN L DOUGHTY (NP)

  • 39500;39520, Liberty Street, Fremont, Alameda County, California, 94536, United States

    FREMONT, CA 94538

    Phone: (510) 252-5897

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-06-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100626000505INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94538)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658349824View full group profile
NameSpecialtyState
Registered Dietitian Or Nutrition ProfessionalCA
Internal MedicineCA
Pediatric MedicineCA
Internal MedicineCA
Internal MedicineCA
Nurse PractitionerMO
Internal MedicineCA
Internal MedicineCA
Nurse PractitionerCA
Clinical PsychologistCA

Reviews

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Frequently asked questions

What federal number belongs to SUSAN L DOUGHTY (NP)?
The federal identifier for SUSAN L DOUGHTY (NP) is NPI 1285676759.
Is SUSAN L DOUGHTY (NP) currently active in the NPI registry?
CMS-published data lists SUSAN L DOUGHTY (NP) as an active registrant.
What field does SUSAN L DOUGHTY (NP) work in?
You can think of SUSAN L DOUGHTY (NP) as practicing within Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for SUSAN L DOUGHTY (NP)?
We surface Fremont, California for SUSAN L DOUGHTY (NP) based on available NPPES addresses.
How can I contact SUSAN L DOUGHTY (NP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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