Peter Fitzgibbons, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

60380 Issued in AZ

Practice address

4212 N 16TH St
Phoenix, AZ 85016-5319

Phone

(602) 263-1507

NPI assigned

Apr 20, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  dba Phoenix Indian Medical Center

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1083643738

  TX

  Medicare reassignment NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  dba Ak-Chin Clinic

  • Public Health or Welfare Agency
  • Maricopa, AZ
  • NPI 1538043443
  NPD

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1295260826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGIBBONS",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "60380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo Ellen Fitzgerald
• John Fitzgerald, M.D.
• Michele Marie Fitzgerald, RN
• Randy R. Fitzgerald, DDS
• Molly Fitzgibbons, FNP-C
• Blythe A Fitzharris, PH.D., LCSW
• Grace Lauren Fitzpatrick
• Jennifer Fitzpatrick, DVM
• Tiffany Fitzsimmons, M.S., OTR/L
• Joan Marie Fiumara, FNP-C

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.