Active NPI
Frank A. Fetterolf, MD
- Psychiatry Physician
- Pittsburgh, PA
National Provider Identifier
1285977439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD458353
- Practice address
- 401 Shady Ave Ste D103
Pittsburgh, PA 15206-4460 - Phone
- (412) 832-9949
- Fax
- (510) 275-0490
- NPI assigned
- Apr 5, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD458353 | PA | Primary |
Addresses
Primary practice location
401 Shady Ave Ste D103
Pittsburgh, PA 15206-4460
Mailing address
401 Shady Ave Ste D103
Pittsburgh, PA 15206-4460
Phone (412) 832-9949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 22, 2017 through May 22, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD458353 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665273600000",
"number": "1285977439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 SHADY AVE STE D103",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152064460",
"telephone_number": "412-832-9949",
"fax_number": "510-275-0490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 SHADY AVE STE D103",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152064460",
"telephone_number": "412-832-9949",
"fax_number": "510-275-0490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETTEROLF",
"first_name": "FRANK",
"middle_name": "A.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-05",
"last_updated": "2022-10-09",
"certification_date": "2022-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD458353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.