Active NPI
Thomas E Fitzgerald, MD
- Surgery Physician
- Quincy, MA
National Provider Identifier
1114917879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 51025
- Practice address
- 700 Congress St
Ste 304
Quincy, MA 02169-0909 - Phone
- (617) 479-7333
- Fax
- (617) 773-0198
- NPI assigned
- Oct 25, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 51025 | MA | Primary |
Addresses
Primary practice location
700 Congress St
Ste 304
Quincy, MA 02169-0909
Mailing address
700 Congress St
Ste 304
Quincy, MA 02169-0909
Phone (617) 479-7333
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8164 | Other | MA | HPHC |
| 051025 | Other | MA | TUFTS |
| 6175732 | Medicaid | MA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51025 | MA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282608000000",
"number": "1114917879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 CONGRESS ST",
"address_2": "STE 304",
"city": "QUINCY",
"state": "MA",
"postal_code": "021690909",
"telephone_number": "617-479-7333",
"fax_number": "617-773-0198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 CONGRESS ST",
"address_2": "STE 304",
"city": "QUINCY",
"state": "MA",
"postal_code": "021690909",
"telephone_number": "617-479-7333",
"fax_number": "617-773-0198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "THOMAS",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-25",
"last_updated": "2010-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "51025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC",
"identifier": "8164",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "051025",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6175732",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.