DR. DANIELLE DOUGHERTY (MD) – Pediatric Surgery Physician, NPI 1285017905
Pediatric Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,444 GENERAL SURGERY in MI
Provider Addresses for DR. DANIELLE DOUGHERTY (MD)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 481095000
Phone:
Type: Mailing
282 Washington St
Hartford, CT 061063322
Phone: (860) 545-9520
Type: Location
4440 W 95th St Ste 1332H
Oak Lawn, IL 604532600
Phone: (708) 684-2016
Fax: (708) 684-4808
Type: Location
150 HARVESTER DR STE 300
BURR RIDGE, IL 605275965
Phone:
Type: Mailing
5841 S MARYLAND AVE
CHICAGO, IL 606371443
Phone: (888) 824-0200
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.
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: 2025-11-05
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 |
|---|---|---|---|---|
| I20221220001419 | I | General Surgery | MI | TBD |
| I20251105001343 | I | General Surgery | IL | 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 48109)
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