Dale Walter Fitzpatrick, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G65940 Issued in CA

Practice address

1717 Coffee Rd
Modesto, CA 95355-2808

Phone

(209) 529-0531

Fax

(209) 529-5219

NPI assigned

Sep 25, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1376644492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552808",
            "telephone_number": "209-529-0531",
            "fax_number": "209-529-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552808",
            "telephone_number": "209-529-0531",
            "fax_number": "209-529-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "DALE",
        "middle_name": "WALTER",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G65940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Curtis Fitzgerald, CPO
• Ian Timothy Fitzgerald, PA-C
• John Fitzgerald
• Michelle Don Fitzgerald
• Fitzpatrick ,Mary,DDS Inc
• Mary Lou Fitzpatrick, DDS
• Michael Edward Fitzpatrick, M.D.
• Five Leaf Colver Trucking LLC
• Kristen E. Flack, AGNP
• Francis R Flaim, MD

• Family Medicine Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.