Deven J. Fetzek, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C03348 Issued in MD

Practice address

995 Prince Frederick Blvd Ste 204
Prince Frederick, MD 20678-5101

Phone

(443) 351-3376

NPI assigned

Oct 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anne Arundel Dermatology PAGroup PAC ID 6608761960, 126 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.75 of 100Reported as group

Promoting interoperability

95

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dfetzek@aadermaffiliates.emadirect.md

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.

• Anne Arundel Dermatology LLC

  • Dermatology Physician
  • Annapolis, MD
  • NPI 1063481703
  Medicare reassignment Care Compare group
• Anne Arundel Dermatology, PA

  • Dermatology Physician
  • Prince Frederick, MD
  • NPI 1568292282
  NPD

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1326290511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 PRINCE FREDERICK BLVD STE 204",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206785101",
            "telephone_number": "443-351-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 PRINCE FREDERICK BLVD STE 204",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206785101",
            "telephone_number": "443-351-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETZEK",
        "first_name": "DEVEN",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C03348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph S. Fastow, M.D.
• Jennifer Faulkner
• Jonathan Kim Fears, MD
• Erica T. Ferges
• Kenneth L Ferrera, PA-C
• Jennifer Fifield, LGPC
• Hannah Rose Filippelli, CRNP
• Finizio - Radiology Imaging Associates, PC
• First Class Ambulance Services LLC
• Eileen Fitzsimmons

• Physician Assistant in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.