Daniel James Fitzgerald, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036146100 Issued in IL

Practice address

12935 Gregory St
Blue Island, IL 60406

Phone

(708) 597-2000

NPI assigned

May 5, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, CA2 enrollments

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 2

Specialty

Family Practice

Education

Virginia Commonwealth University, School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Superior Hospitalist Medical Group IncGroup PAC ID 1456650928, 75 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Martin Luther King, Jr. Community Hospital Hospital, Los Angeles, CA, CCN 050779

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Superior Hospitalist Medical Group Inc

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1780047712

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Advance Inpatient Medicine LLC

  • Hospitalist Physician
  • Oak Brook, IL
  • NPI 1265989875
  Medicare reassignment NPD

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

• Martin Luther King, Jr. - Los Angeles (MLK-la) Healthcare Corporation

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114367497
  Care Compare affiliation

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1093007221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "METROSOUTH MEDICAL CENTER",
            "address_2": "12935 S GREGORY ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "60406",
            "telephone_number": "708-597-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12935 GREGORY ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "60406",
            "telephone_number": "708-597-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-05",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036146100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.