Individual provider Active NPI

Laurence N Fitzhenry IV, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Vineland, NJ
National Provider Identifier
1275745655
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
25MA09824900 Issued in NJ
Practice address
352 S Delsea Dr Ste C
Vineland, NJ 08360-5306
Phone
(856) 690-1616
Fax
(856) 690-1089
NPI assigned
May 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD437420 PA
Pain Medicine (Anesthesiology) Physician 207LP2900X MD437420 PA
Pain Medicine (Anesthesiology) Physician 207LP2900X 25MA09824900 NJ Primary

Addresses

Primary practice location

352 S Delsea Dr Ste C
Vineland, NJ 08360-5306

Mailing address

352 S Delsea Dr Ste C
Vineland, NJ 08360-5306
Phone (856) 690-1616

Other identifiers 1

IdentifierTypeStateIssuer
102319486MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160223000817 NJ Practitioner - Physical Medicine and RehabilitationPractitioner - Anesthesiology 1951479542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Anesthesiology
Education
Jefferson Medical College of Thomas Jefferson University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

298 S Delsea Dr
Vineland, NJ 08360-4568
Phone (856) 690-1616

800 Jessup Rd
Suite 809
West Deptford, NJ 08086-9354
Phone (856) 690-1616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
19.16 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
63.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09824900NJMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC CurrentSince Mar 7, 2016 Accepting new patients
Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC CurrentSince Mar 7, 2016 Accepting new patients
Capa Anesthesia LLC Anesthesiology Past Accepting new patients
Cap Anesthesia, PC Anesthesiology Past Accepting new patients
Society Hill Anesthesia Consultants of New Jersey, PC Anesthesiology Past Accepting new patients

Locations

352 S Delsea Dr
Unit C
Vineland, NJ 08360
Phone 8566901616 ext. 6021

298 S Delsea Dr
Vineland, NJ 08360
Phone (356) 690-1616

Interoperability endpoints

  • Direct secure messaging: laurence.fitzhenry@poasnj.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1275745655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 S DELSEA DR STE C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605306",
            "telephone_number": "856-690-1616",
            "fax_number": "856-690-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 S DELSEA DR STE C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605306",
            "telephone_number": "856-690-1616",
            "fax_number": "856-690-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZHENRY",
        "first_name": "LAURENCE",
        "middle_name": "N",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD437420",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD437420",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MA09824900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102319486",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.