Individual provider Active NPI

Robert T Fritz, M.D.

  • Otolaryngology Physician
  • Beverly, MA
National Provider Identifier
1215908025
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
40921 Issued in MA
Practice address
75 Herrick St
Suite 113
Beverly, MA 01915-5903
Phone
(978) 921-0944
Fax
(978) 927-5844
NPI assigned
Jan 30, 2006
Last updated
Aug 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 40921 MA Primary

Addresses

Primary practice location

75 Herrick St
Suite 113
Beverly, MA 01915-5903

Mailing address

75 Herrick St
#113
Beverly, MA 01915-5903
Phone (978) 921-0944

Other identifiers 1

IdentifierTypeStateIssuer
2052784MedicaidMA

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

LicenseStateTypeSpecialty
40921MAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert T. Fritz, M.D. P.C. Otolaryngology PastSince Jun 3, 2002 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1215908025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 HERRICK ST",
            "address_2": "#113",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155903",
            "telephone_number": "978-921-0944",
            "fax_number": "978-927-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 HERRICK ST",
            "address_2": "SUITE 113",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155903",
            "telephone_number": "978-921-0944",
            "fax_number": "978-927-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITZ",
        "first_name": "ROBERT",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "40921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2052784",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.