Active NPI
Marcie L Fitzgerald, PA-C
- Physician Assistant
- Erie, PA
National Provider Identifier
1033170469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA002756L
- Practice address
- 1645 West 8TH Street
Shriners Hospitals for Children Erie
Erie, PA 16505-5097 - Phone
- (814) 875-8728
- Fax
- (814) 875-8796
- NPI assigned
- Mar 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA002756L | PA | Primary |
Addresses
Primary practice location
1645 West 8TH Street
Shriners Hospitals for Children Erie
Erie, PA 16505-5097
Mailing address
PO Box 8500 Lockbox #7642
Shriners Hospitals for Children
Philadelphia, PA 19178-7642
Phone (813) 281-8478
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA002756L | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shriners Hospitals for Children | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349049600000",
"number": "1033170469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8500 LOCKBOX #7642",
"address_2": "SHRINERS HOSPITALS FOR CHILDREN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191787642",
"telephone_number": "813-281-8478",
"fax_number": "813-281-8113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1645 WEST 8TH STREET",
"address_2": "SHRINERS HOSPITALS FOR CHILDREN ERIE",
"city": "ERIE",
"state": "PA",
"postal_code": "165055097",
"telephone_number": "814-875-8728",
"fax_number": "814-875-8796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "MARCIE",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-28",
"last_updated": "2012-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA002756L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.