JOHN DOUGHERTY – Internal Medicine Physician, NPI 1053722934
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
190 INFECTIOUS DISEASE in IN
Provider Addresses for JOHN DOUGHERTY
56 WILLOW ST
VALPARAISO, IN 463834223
Phone: (219) 309-7254
Type: Location
5767 W CENTURY BLVD STE 400
LOS ANGELES, CA 900455631
Phone:
Type: Mailing
8641 WILSHIRE BLVD STE 210
BEVERLY HILLS, CA 902112920
Phone: (310) 855-7002
Fax: (310) 855-7003
Type: Location
PO BOX 781076
DETROIT, MI 482781076
Phone: (317) 528-4800
Fax: (317) 865-1479
Type: Mailing
3500 FRANCISCAN WAY STE 300
MICHIGAN CITY, IN 463600033
Phone: (219) 861-5539
Fax: (219) 861-5725
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2024-02-27 • Largest payer in this snapshot: Takeda Pharmaceuticals U.S.A., Inc. ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Takeda Pharmaceuticals U.S.A., Inc. | $13 |
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: 2017-12-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170818000104 | I | Internal Medicine | TX | TBD |
| I20171222000381 | I | Internal Medicine | GU | TBD |
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.
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 46383)
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Reviews
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