Dr Sean Michael Dougherty, DPM - Medicare Podiatrist in Fairfield, CA

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Dr Sean Michael Dougherty, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Fairfield, California. He graduated from medical school in 2009 and has 15 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Jiva Health, Inc and his current practice location is 1620 Pennsylvania Ave Ste A, Fairfield, California. You can reach out to his office (for appointments etc.) via phone at (707) 426-5644.

Dr Sean Michael Dougherty is licensed to practice in California (license number E5009) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1407089261.

Contact Information

Dr Sean Michael Dougherty, DPM
1620 Pennsylvania Ave Ste A,
Fairfield, CA 94533-3509
(707) 426-5644
(707) 426-3156

Map and Direction




Healthcare Provider's Profile

Full NameDr Sean Michael Dougherty
GenderMale
SpecialityPodiatry
Experience15 Years
Location1620 Pennsylvania Ave Ste A, Fairfield, California
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Sean Michael Dougherty graduated from medical school in 2009
  NPI Data:
  • NPI Number: 1407089261
  • Provider Enumeration Date: 08/27/2009
  • Last Update Date: 09/02/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 5890951230
  • Enrollment ID: I20120730000365

Medical Identifiers

Medical identifiers for Dr Sean Michael Dougherty such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1407089261NPI-NPPES
P01083197OtherCAMEDICARE RAILROAD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
213E00000XPodiatrist E5009 (California)Secondary
213EP1101XPodiatrist - Primary Podiatric Medicine E5009 (California)Secondary
213ES0000XPodiatrist - Sports Medicine E5009 (California)Secondary
213ES0103XPodiatrist - Foot & Ankle Surgery E5009 (California)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Jiva Health, Inc509211510517

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Sean Michael Dougherty allows following entities to bill medicare on his behalf.
Provider NameDr. Sean Dougherty, Dpm, Inc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1518573310
PECOS PAC ID: 1254741507
Enrollment ID: O20201028000693
Provider NameJiva Health, Inc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1285223552
PECOS PAC ID: 5092115105
Enrollment ID: O20210610003376

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Sean Michael Dougherty is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Sean Michael Dougherty, DPM
1620 Pennsylvania Ave Ste A,
Fairfield, CA 94533-3509

Ph: (707) 426-5644		Dr Sean Michael Dougherty, DPM
1620 Pennsylvania Ave Ste A,
Fairfield, CA 94533-3509

Ph: (707) 426-5644

Reviews and Comments


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Giang Hong Duc Son, D.P.M
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Dr. Kevin Michael Miller, DPM
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Camilla Willson,
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Practice Location: 1620 Pennsylvania Ave Ste A, Fairfield, CA 94533
Phone: 707-426-5644    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.