Individual provider Active NPI

Audrey Catherine Fortezzo, PA-C

  • Physician Assistant
  • Asheville, NC
National Provider Identifier
1023547585
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Hospital Dr Ste 4200
Asheville, NC 28801-4550
Phone
(828) 213-1994
NPI assigned
Jun 8, 2017
Last updated
Jan 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Surgical Physician Assistant 363AS0400X 0010-07529 NC

Addresses

Primary practice location

1 Hospital Dr Ste 4200
Asheville, NC 28801-4550

Mailing address

1 Hospital Dr Ste 4200
Asheville, NC 28801-4550
Phone (828) 213-1994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171130002654 NC Practitioner - Physician Assistant 1658638531 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

21 Hospital Dr
Asheville, NC 28801-4550

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-2325

55 Piney Mountain Dr
Asheville, NC 28805-1297
Phone (828) 252-1915

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Community Anesthesiology Specialists LLC CurrentSince Mar 1, 2021 Accepting new patients
DLP Haywood Regional Medical Center LLC CurrentSince Nov 17, 2019 Accepting new patients
DLP Western Carolina Physician Practices LLC Physician Assistant CurrentSince Sep 18, 2017 Accepting new patients
DLP Western Carolina Physician Practices LLC CurrentSince Sep 18, 2017 Accepting new patients
Mission Community Anesthesiology Specialists LLC Past Accepting new patients
Haywood Women's Medical Center, PA Past Accepting new patients

Locations

1 Hospital Dr
Ste 4200
Asheville, NC 28801
Phone (828) 213-1994

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

581 Leroy George Dr
Ste 300
Clyde, NC 28721
Phone (828) 452-4131

98 Doctors Dr
Ste 200
Sylva, NC 28779
Phone (828) 586-8971

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1023547585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR STE 4200",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014550",
            "telephone_number": "828-213-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR STE 4200",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014550",
            "telephone_number": "828-213-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTEZZO",
        "first_name": "AUDREY",
        "middle_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-07529",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.