NPIMap

Organization Active NPI

Patrick Fettinger, DPM

  • Customized Equipment (DME)
  • New Fairfield, CT
National Provider Identifier
1104000330
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
00625 Issued in CT
Legal business name
PATRICK FETTINGER, DPM
Practice address
88 State Route 37
Fieldstone Plaza
New Fairfield, CT 06812-5036
Phone
(203) 746-9660
Fax
(203) 746-4186
NPI assigned
Dec 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Authorized official

Name
Dr. Patrick Fettinger, DPMNPI 1750372272
Title
Owner
Phone
(203) 746-9660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 625 CT
Customized Equipment (DME) 332BC3200X 00625 CT Primary

Addresses

Primary practice location

88 State Route 37
Fieldstone Plaza
New Fairfield, CT 06812-5036

Mailing address

PO Box 8236
New Fairfield, CT 06812
Phone (203) 746-9660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930072815 CT DME Supplier - Physician - Podiatry 7315059987 Practice locations: New Fairfield, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Patrick Fettinger DPM2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1104000330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8236",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "06812",
            "telephone_number": "203-746-9660",
            "fax_number": "203-746-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 STATE ROUTE 37",
            "address_2": "FIELDSTONE PLAZA",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "068125036",
            "telephone_number": "203-746-9660",
            "fax_number": "203-746-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK FETTINGER, DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "FETTINGER",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-746-9660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "625",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CT",
            "license": "00625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.