Frazier T Fortenberry Jr., MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

0101044989 Issued in VA

Practice address

630 Peter Jefferson Pkwy
Suite 135
Charlottesville, VA 22911-8605

Phone

(434) 244-5722

Fax

(434) 244-5723

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Urology

Education

Louisiana State University School of Medicine in New Orleans, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Martha Jefferson Hospital Hospital, Charlottesville, VA, CCN 490077

Merit-based Incentive Payment System (MIPS)

Final score

30 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

100

Procedures performed for Medicare patients

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.

• Frazier T Fortenberry Jr MD PLC

  • Urology Physician
  • Charlottesville, VA
  • NPI 1215960224
  Medicare reassignment NPD Authorized official
• Piedmont Stone Center PLLC

  • Lithotripsy Clinic/Center
  • Winston-Salem, NC
  • NPI 1700827409

  Urology, VA

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Martha Jefferson Hospital

  • General Acute Care Hospital
  • Charlottesville, VA
  • NPI 1346248663
  Care Compare affiliation

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1376530816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PETER JEFFERSON PKWY",
            "address_2": "SUITE 135",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118605",
            "telephone_number": "434-244-5722",
            "fax_number": "434-244-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PETER JEFFERSON PKWY",
            "address_2": "SUITE 135",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118605",
            "telephone_number": "434-244-5722",
            "fax_number": "434-244-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTENBERRY",
        "first_name": "FRAZIER",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101044989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH",
            "identifier": "14120",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "23555",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM SERVICES",
            "identifier": "461522",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "P00003207",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "367104",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "204175",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "340000300",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Forget, MD
• Katherine T, Forkin, M.D.
• Megan P Forney, MD
• Maria P Forstner, AG-PCNP
• Abigail Forsyth
• Kathryn Ann Fortune
• Joshua Wilson Foskett, LCSW
• Ansley Foster, OTR
• Celia Foster, MD
• Lisa W. Foster, P.A.

• Urology Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Urology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.