CHRISTOPHER R DOUGHERTY (AA) – Anesthesiologist Assistant, NPI 1720336548
Anesthesiologist Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
357 ANESTHESIOLOGY ASSISTANT in MO
Provider Addresses for CHRISTOPHER R DOUGHERTY (AA)
1235 E Cherokee St
Springfield, MO 658042203
Phone: (417) 820-2829
Fax: (417) 820-8852
Type: Location
1235 E CHEROKEE ST
SPRINGFIELD, MO 658042203
Phone: (417) 820-2829
Fax: (417) 820-8852
Type: Location
PO BOX 2580
SPRINGFIELD, MO 658012580
Phone: (417) 829-4620
Type: Mailing
11141 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 468451714
Phone: (260) 425-6030
Fax: (260) 425-6028
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: 2024-12-09
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 |
|---|---|---|---|---|
| I20201026000557 | I | Anesthesiology Assistant | GA | TBD |
| I20241209002453 | I | Anesthesiology Assistant | IN | 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 |
|---|---|---|---|---|
| 00813 | Anesthesia for procedure on small and large bowel using an endoscope | 11 | 11 | $0 |
Insurance plans in this area (ZIP 65804)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY ASSISTANT | MO | 00142 | Anesthesia for lens surgery | 46 | 46 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Nurse Practitioner | NM | |
| - | IN | |
| Nurse Practitioner | IN | |
| Family Practice | IN | |
| - | IN | |
| - | IN | |
| Infectious Disease | IN | |
| Internal Medicine | IN | |
| - | IN |
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