Fred K Fioravanti, MD

Individual provider Active NPI Family Medicine Physician · Cabot, PA

NPI 1285620906 · NPPES record last updated Apr 23, 2016

Key facts

NPI
1285620906
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
MD025211E (PA)
Practice address
112 Marwood Rd
#5000
Cabot, PA 16023-2239
Phone
(724) 352-4448
Fax
(724) 352-4412
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20071214000086 PA Practitioner - Family Practice
Practitioner - Geriatric Medicine
1153411160 Receives reassigned benefits from 1 practitioner
Practice locations: Cabot, PA

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fred K. Fioravanti Past
since Jan 1, 1990
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD025211E PA Yes
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD025211E PA

Addresses

Primary practice location

112 Marwood Rd
#5000
Cabot, PA 16023-2239

Mailing address

112 Marwood Rd
#5000
Cabot, PA 16023-2239
Phone (724) 352-4448

Other identifiers

IdentifierTypeStateIssuer
00100247003MedicaidPA

Other providers in Cabot, PA

All providers in Cabot, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.