Michael John Doherty, ATC, LAT, DPT
NPI 1730616574ActiveIndividual· Specialist/Technologist, Athletic Trainer· Munster, IN
Specialist/Technologist, Athletic Trainer (ATC, LAT, DPT) with Bentonville Physical Therapy Specialists, practicing in Munster, Indiana. Medicare paid $2,256 for services to 11 patients in 2024.
Overview
| NPI | 1730616574 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | ATC, LAT, DPT |
| Sole proprietor | Yes |
| NPI issued | May 11, 2017 |
| Last updated in NPPES | May 11, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist/Technologist, Athletic Trainer Primary | 2255A2300X | 36002268A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (AR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 11 |
|---|---|
| Services billed | 106 across 8 procedure codes |
| Paid by Medicare | $2,256 |
Education and affiliations
| Graduation year | 2017 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Bentonville Physical Therapy SpecialistsBentonville, AR · 2 clinicians
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