Colleen McCamant Fitzpatrick, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD431533 Issued in PA

Practice address

5649 Wynnewood Dr
Suite 104
Laurys Station, PA 18059-1138

Phone

(610) 262-6641

Fax

(610) 262-0428

NPI assigned

May 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Lehigh Valley Physician Group

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650

  Pediatrics

  NPD
• Lehigh Valley Physician Group

  • Internal Medicine Physician
  • Tobyhanna, PA
  • NPI 1629833579
  NPD

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1154522266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5649 WYNNEWOOD DR",
            "address_2": "SUITE 104",
            "city": "LAURYS STATION",
            "state": "PA",
            "postal_code": "180591138",
            "telephone_number": "610-262-6641",
            "fax_number": "610-262-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "COLLEEN",
        "middle_name": "MCCAMANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD431533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD431533",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisa Chanchenchop, DO
• Chin Chan Chu, MD
• Kelsey Emery, CRNP
• Gina Fitzsimmons, DO
• Danielle M Fuller-Sincock, MD
• Richard Gould, CRNP
• Thomas Paul Harakal, M.D.
• Michael Dominic Hoffman, MD

• Pediatrics Physician in Laurys Station, PA
• Providers in Laurys Station, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.