Individual provider Active NPI

Lorenzo Fitzig, M.D.

  • Cardiovascular Disease Physician
  • Rego Park, NY
National Provider Identifier
1073519856
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
139348 Issued in NY
Practice address
9901 Queens Blvd
Rego Park, NY 11374-4512
Phone
(718) 520-6100
Fax
(718) 544-6664
NPI assigned
Jun 25, 2005
Last updated
Oct 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 139348 NY Primary

Addresses

Primary practice location

9901 Queens Blvd
Rego Park, NY 11374-4512

Mailing address

9901 Queens Blvd
Rego Park, NY 11374-4512
Phone (718) 520-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070122000626 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0042211864 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
139348NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Cardiovascular Disease CurrentSince Feb 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai Cardiovascular Disease CurrentSince Dec 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 1, 2013 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Cardiovascular Disease CurrentSince Feb 1, 2020 Accepting new patients
Brooklyn Nuclear Spect Imaging, PC Cardiovascular Disease Past Accepting new patients
Nuclear Cardiac and Medical Imaging Services, PC Cardiovascular Disease Past Accepting new patients

Locations

6915 Yellowstone Blvd
Forest Hills, NY 11375
Phone (718) 268-4500

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

10114 Liberty Ave
Ozone Park, NY 11417
Phone (718) 487-3330

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1119657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1073519856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744512",
            "telephone_number": "718-520-6100",
            "fax_number": "718-544-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744512",
            "telephone_number": "718-520-6100",
            "fax_number": "718-544-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZIG",
        "first_name": "LORENZO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-25",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "139348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.