NPIMap

Individual provider Active NPI

Fitzgerald Marcelin Sr., MD

  • Internal Medicine Physician
  • Emporia, VA
National Provider Identifier
1285818229
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101231381 Issued in VA
Practice address
702 N Main St
Emporia, VA 23847-1242
Phone
(434) 634-7723
Fax
(434) 634-7725
NPI assigned
Dec 27, 2007
Last updated
Feb 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101231381 VA Primary
Pediatrics Physician 208000000X 0101231381 VA

Addresses

Primary practice location

702 N Main St
Emporia, VA 23847-1242

Mailing address

PO Box 70
Victoria, VA 23974-0070
Phone (434) 696-2165

Other identifiers 3

IdentifierTypeStateIssuer
1285818229MedicaidVA
89065FCMedicaidNC
5861128MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081218000757 VA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 0244392660 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Medical College of Pennsylvania, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13855 Courthouse Rd
Dinwiddie, VA 23841-2254
Phone (804) 469-3731

727 N Main St
Emporia, VA 23847-1274
Phone (240) 686-2300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101231381VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Dominion Health System, Inc. Current Accepting new patients
Emergency Medicine Associates, P.a.,P.C. Internal Medicine CurrentSince May 10, 2019 Accepting new patients
Southern Dominion Health System, Inc. CurrentSince Jul 26, 2017 Accepting new patients
Southern Dominion Health System, Inc. CurrentSince Jul 26, 2017 Accepting new patients
Alexandria Springfield Emergency Physicians PC CurrentSince Dec 18, 2019 Accepting new patients
Alexandria Springfield Emergency Physicians PC CurrentSince Dec 18, 2019 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince May 10, 2019 Accepting new patients
Terrebonne Parish Hospital Service District #1 Internal Medicine Past Accepting new patients
Antoinette D. Adams, DPM, PC PastSince Mar 4, 2010 Accepting new patients

Locations

8920 Otterburn Rd
Amelia Ct Hse, VA 23002
Phone (804) 288-8838

60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 765-5000

13855 Courthouse Rd
Dinwiddie, VA 23841
Phone (804) 469-3731

510 N Main St
Emporia, VA 23847
Phone (434) 634-7723

702 N Main St
Emporia, VA 23847
Phone (434) 634-7723

727 N Main St
Emporia, VA 23847
Phone (434) 348-4400

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

1508 K V Rd
Victoria, VA 23974
Phone (434) 696-2165

Interoperability endpoints

  • Direct secure messaging: fitzgerald.marcelin@sdhs.directbygreenway.com

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1285818229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "VICTORIA",
            "state": "VA",
            "postal_code": "239740070",
            "telephone_number": "434-696-2165",
            "fax_number": "434-696-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N MAIN ST",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "238471242",
            "telephone_number": "434-634-7723",
            "fax_number": "434-634-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELIN",
        "first_name": "FITZGERALD",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-27",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101231381",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101231381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285818229",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89065FC",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5861128",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporia, VA

Sources for this page

Verify at the official NPI Registry.