IAN DOHERTY (CRNA) – Certified Registered Nurse Anesthetist, NPI 1023683984

IAN DOHERTY (CRNA) is a healthcare provider. based in Burlington, Massachusetts. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 086161-23 (NH). The NPI Number for IAN DOHERTY (CRNA) is 1023683984

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
IAN DOHERTY (CRNA)
NPI
1023683984
Phone
(781) 744-8000
Address
41 Mall Rd
Enumeration Date
24 May 2021
Last Update Date
8 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8572828100
Graduation Year
2022 (4 years ago)
PAC ID
8022491570
Group Practice PAC ID
3971987108
Professional Enrollment ID
I20221115001943
Address ID
MA018034945BU47XXXTPKE300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:5State licenses:2Digital endpointsOther names

1,311 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MA

Provider Addresses for IAN DOHERTY (CRNA)

  • 41 Mall Rd

    Burlington, MA 01805

    Phone: (781) 744-8000

    Type: Location

  • PROVIDER ENROLLMENT 41 MALL ROAD

    BURLINGTON, MA 018050001

    Phone: (781) 744-8085

    Type: Mailing

  • 1 ELLIOT WAY STE 200

    MANCHESTER, NH 031033502

    Phone:

    Type: Mailing

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: 2022-11-15

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
I20221115001943ICertified Registered Nurse Anesthetist (Crna)MATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope3131$0
00811Anesthesia for other procedure on large bowel using an endoscope2828$0
00813Anesthesia for procedure on small and large bowel using an endoscope1616$0
01402Anesthesia for procedure for total knee joint replacement1313$0
00918Anesthesia for fragmenting, manipulation and/or removal of kidney stone including use of an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 01805)

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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: 3971987108View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)SC
A N E S T H E S I O L O G YMA
Internal MedicineOH
A N E S T H E S I O L O G YMA
A N E S T H E S I O L O G YMN
Internal Medicine, HospitalistMA
A N E S T H E S I O L O G YMA
A N E S T H E S I O L O G YNH
Cardiovascular Disease (Cardiology), Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)MA
A N E S T H E S I O L O G YMA

Reviews

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Frequently asked questions

Can I verify IAN DOHERTY (CRNA) with an NPI only?
You can start verification with NPI 1023683984 for IAN DOHERTY (CRNA), then check state licensing separately.
Can I rely on IAN DOHERTY (CRNA) being an active provider?
As of the registry snapshot, IAN DOHERTY (CRNA) is marked active.
What taxonomy line describes IAN DOHERTY (CRNA)?
For research purposes, treat IAN DOHERTY (CRNA) as Certified Registered Nurse Anesthetist in this dataset. Clinical services aligned with this taxonomy classification.
Does IAN DOHERTY (CRNA) list a practice location?
Patients near Burlington, Massachusetts may find IAN DOHERTY (CRNA) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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