Simon Michael Fitzgerald, MPH

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

12322090 Issued in NY

Practice address

450 Clarkson Ave
Brooklyn, NY 11203-2012

Phone

(410) 466-1713

NPI assigned

Jun 4, 2011

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

Enrolled in NY

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

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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.

• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty practice Group

  • Orthopaedic Surgery Physician
  • Elmhurst, NY
  • NPI 1609120674
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Surgery Physician
  • Elmhurst, NY
  • NPI 1073867040
  NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1619221686
  NPD
• New York City Health and Hospitals Corporation

  dba Kings County Hospital Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1043224355
  NPD (past)
• New York City Health and Hospitals Corporation

  dba Jacobi Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1307145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307145600000",
    "number": "1407140767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 SULGRAVE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094515",
            "telephone_number": "410-466-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "410-466-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "SIMON",
        "middle_name": "MICHAEL",
        "credential": "MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-04",
        "last_updated": "2011-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "12322090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Fitzgerald, SLP
• Eugene Fitzgerald, LCSW-R
• Jane Fitzgerald
• Jill Elizabeth Fitzgerald, LCSW
• Paul Thomas Fitzgerald, LCSW
• Teona Fitzgerald
• Felicia Brigid Fitzpatrick-Lucey, LCSW
• Christine M Fitzpatrick, M.D.
• Claire Patricia Fitzpatrick, D.C.
• Edward Fitzpatrick, MD

• Student in an Organized Health Care Education/Training Program in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.