DR. KEVIN S. DOUGHERTY (D.O.) – Emergency Medicine Physician, NPI 1922412279
Emergency Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
111 EMERGENCY MEDICINE in WY
Provider Addresses for DR. KEVIN S. DOUGHERTY (D.O.)
707 SHERIDAN AVE
CODY, WY 824143409
Phone: (307) 578-2000
Type: Mailing
111 E WISCONSIN AVE STE 2000
MILWAUKEE, WI 532024809
Phone: (414) 290-6720
Fax: (414) 290-6755
Type: Mailing
1726 SHAWANO AVE
GREEN BAY, WI 543033216
Phone: (414) 290-6720
Fax: (414) 290-6755
Type: Location
1726 Shawano Ave
Green Bay, WI 543033216
Phone: (414) 290-6720
Fax: (414) 290-6755
Type: Location
835 S Van Buren St
Green Bay, WI 543013526
Phone: (414) 290-6720
Fax: (414) 290-6755
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: 2023-11-10
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 |
|---|---|---|---|---|
| I20180727000887 | I | Emergency Medicine | WI | TBD |
| I20231110000565 | I | Emergency Medicine | WY | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 72 | 72 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 53 | 53 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 42 | 42 | $0 |
| 99291 | Critical care, first 30-74 minutes | 23 | 23 | $0 |
Insurance plans in this area (ZIP 82414)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | IL | |
| Emergency Medicine | IL | |
| Emergency Medicine | WI | |
| Emergency Medicine | WI | |
| Emergency Medicine | WI | |
| Emergency Medicine | WI | |
| Emergency Medicine | WI | |
| Emergency Medicine | WI | |
| Emergency Medicine | IL | |
| Pulmonary Disease, Critical Care (Intensivists), Emergency Medicine | AL |
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