Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sandra Dougherty, PA

Individual provider Physician Assistant · NPI 1104294677

Sandra Dougherty, PA is a Physician Assistant in Montoursville, Pennsylvania. Qualified in 2015, 11 years ago. Practices with Walnut Bottom Family Practice, LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
11
Licensed in
PA
In the registry since
2015
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

780 Broad St
Montoursville, PA 17754-2419
Phone: (570) 368-2870
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA0057727 (PA)
Physician Assistant Taxonomy 363A00000X · Licence OA003593 (PA)

Record details

NPI number1104294677
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 14, 2015
Last updated in NPPESSeptember 14, 2015
Mailing address780 Broad St, Montoursville, PA 17754-2419

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Walnut Bottom Family Practice, Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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