Active NPI
Krista Fitzgerald
- Social Worker
- Port Jervis, NY
National Provider Identifier
1396690418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 130250-01
- Practice address
- 10 US Highway 209
Port Jervis, NY 12771-3920 - Phone
- (845) 858-3100
- NPI assigned
- Mar 3, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 130250-01 | NY | Primary |
Addresses
Primary practice location
10 US Highway 209
Port Jervis, NY 12771-3920
Mailing address
432 Logtown Rd
Port Jervis, NY 12771-3345
Phone (845) 649-0548
Other practice location 1
146 Pike St
Port Jervis, NY 12771-1808
Phone (845) 858-1456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130250-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1772496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772496000000",
"number": "1396690418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "432 LOGTOWN RD",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127713345",
"telephone_number": "845-649-0548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 US HIGHWAY 209",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127713920",
"telephone_number": "845-858-3100"
}
],
"practiceLocations": [
{
"address_1": "146 Pike St",
"address_purpose": "LOCATION",
"city": "Port Jervis",
"state": "NY",
"postal_code": "127711808",
"country_code": "US",
"telephone_number": "845-858-1456",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FITZGERALD",
"first_name": "KRISTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-03-03",
"last_updated": "2026-03-03",
"certification_date": "2026-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "130250-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jervis, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.