KELLY ANN DOUGHERTY (CRNA) – Certified Registered Nurse Anesthetist, NPI 1013355981
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,311 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MA
Provider Addresses for KELLY ANN DOUGHERTY (CRNA)
95 WALDEMAR AVE
WINTHROP, MA 021522346
Phone: (617) 461-8029
Type: Mailing
55 FRUIT ST
GRB 444
BOSTON, MA 021142621
Phone: (617) 461-8029
Type: Location
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.
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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: 2013-09-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130911000071 | I | Certified Registered Nurse Anesthetist (Crna) | MA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00104 | Anesthesia for electroshock therapy | 214 | 108 | $0 |
Insurance plans in this area (ZIP 02152)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | MA | |
| Diagnostic Radiology | MA | |
| Nephrology, Internal Medicine | MA | |
| Nurse Practitioner | MA | |
| P A T H O L O G Y | NY | |
| P A T H O L O G Y | MA | |
| P S Y C H I A T R Y | MA | |
| Cardiac Electrophysiology, Internal Medicine, Cardiovascular Disease (Cardiology) | MA | |
| H E M A T O L O G Y/ O N C O L O G Y | MA | |
| N E U R O L O G Y | MA |
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