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

Individual provider Physician Assistant · NPI 1780660761

Simon Francis Dougherty, PA-C is a Physician Assistant in Fresno, California. Qualified in 2004, 22 years ago. Practices with Community Foundation Medical Group, a 284-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
22
Licensed in
CA
In the registry since
2005
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

255 N Herwaldt Dr
Fresno, CA 93701-2186
Phone: (559) 459-7300
Fax: (559) 459-3750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA17805 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA17805 (CA)

Record details

NPI number1780660761
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 21, 2005
Last updated in NPPESJune 30, 2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Community Foundation Medical Group — 284 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fresno