Individual provider Active NPI

Grahame W Fitz, M.D.

  • Family Medicine Physician
  • Latham, NY
National Provider Identifier
1215929377
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
147616 Issued in NY
Practice address
6 Wellness Way Ste 109
Latham, NY 12110-2142
Phone
(518) 785-5882
Fax
(518) 783-8510
NPI assigned
Aug 16, 2005
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 147616 NY Primary

Addresses

Primary practice location

6 Wellness Way Ste 109
Latham, NY 12110-2142

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Other identifiers 1

IdentifierTypeStateIssuer
01160278MedicaidNY

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040901001443 NY Practitioner - Family Practice 7618942558 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
147616NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Health Partners Medical Associates, P.C. Family Medicine CurrentSince Jan 1, 2013 Accepting new patients
Community Care Physicians, PC CurrentSince Aug 11, 2024 Accepting new patients
Community Care Physicians, PLLC Family Medicine CurrentSince May 30, 2023 Accepting new patients
Paul E Lemanski MD PLLC Past Accepting new patients
Capital Eye Care Physicians and Surgeons, PLLC Past Accepting new patients
Prime Care Physicians, P.L.L.C. Family Medicine PastSince Feb 5, 2007 Accepting new patients

Locations

1444 Western Ave
Ste B2
Albany, NY 12203
Phone (518) 458-2611

2 Palisades Dr
Ste 200
Albany, NY 12205

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

1783 Route 9
Ste 202
Halfmoon, NY 12065
Phone (518) 383-2366

6 Wellness Way
Ste 109
Latham, NY 12110
Phone (518) 785-5881

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: gfitz150261@direct.trinity-health.org

Organizations & group practices 6

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1215929377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 109",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102142",
            "telephone_number": "518-785-5882",
            "fax_number": "518-783-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZ",
        "first_name": "GRAHAME",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "147616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01160278",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.