Iljie Kim Fitzgerald, M.D., M.S.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A100934 Issued in CA

Practice address

University of Calif San Francisco Dept of Psychiatry
401 Parnassus Ave RTP 0984
San Francisco, CA 94143-0984

Phone

(415) 476-7000

Fax

(415) 502-2661

NPI assigned

Sep 21, 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

Medicare fee-for-service enrollment

Enrolled in CA

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, Master of Science

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.

• County of Los Angeles

  dba County of Los Angeles Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles Auditor Controller

  dba Los Angeles County Olive View-UCLA Medical Center

  • General Acute Care Hospital
  • Sylmar, CA
  • NPI 1134159320
  NPD
• Schuman-Liles Clinic, Inc

  • Psychiatry Physician
  • Fremont, CA
  • NPI 1164555660
  NPD (past)
• Schuman-Liles Clinic, Inc

  • Psychiatry Physician
  • Oakland, CA
  • NPI 1861568909
  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1205022449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF CALIF SAN FRANCISCO DEPT OF PSYCHIATRY",
            "address_2": "401 PARNASSUS AVE RTP 0984",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430984",
            "telephone_number": "415-476-7000",
            "fax_number": "415-502-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF CALIF SAN FRANCISCO DEPT OF PSYCHIATRY",
            "address_2": "401 PARNASSUS AVE RTP 0984",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430984",
            "telephone_number": "415-476-7000",
            "fax_number": "415-502-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "ILJIE",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A100934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Morgan Fitts
• Fitwell Chiropractic Sports Medicine (Lisa Covey, DC)
• Dorothy Fitzer, MFT
• Allison Lindsay Fitzgerald
• Caroline Fitzgerald, MSOT
• Kelly Nicole Fitzgerald, MD
• Pamela J. Fitzgerald, MSCP, MSCJA
• Patrick Fitzgerald, MFT
• Paul Anthony Fitzgerald, M.D.
• Timothy Martin Fitzgerald

• Psychiatry Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.