DR. RENEE D DOHERTY (MD) – Pediatric Anesthesiology Physician, NPI 1336408103
Pediatric Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,228 ANESTHESIOLOGY in MO
Provider Addresses for DR. RENEE D DOHERTY (MD)
1 Childrens Pl Dept Of
Saint Louis, MO 631101002
Phone: (800) 862-9980
Fax: (314) 362-1185
Type: Location
3140 HARLEQUIN LN
SAINT LOUIS, MO 631391776
Phone: (205) 349-9878
Type: Mailing
3300 GALLOWS RD
DEPARTMENT OF SURGERY
FALLS CHURCH, VA 220423307
Phone: (703) 706-2237
Fax: (703) 776-2338
Type: Location
1000 N Oak Ave # 1000
Marshfield, WI 544495703
Phone: (715) 387-5511
Type: Location
12222 Merit Dr Ste 600
Dallas, TX 752513294
Phone: (972) 715-5000
Fax: (972) 715-9976
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: 2023-06-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20150622001994 | I | Anesthesiology | TX | TBD |
| I20210121001271 | I | Anesthesiology | WI | TBD |
| I20230607002704 | I | Anesthesiology | MO | 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 63110)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| - | MO | |
| - | FL | |
| - | MO | |
| Diagnostic Radiology | IL | |
| - | IL | |
| - | MO | |
| - | MO | |
| - | MO | |
| - | MO |
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