Individual provider Active NPI

William Fitzgerald, PH.D.

  • Clinical Psychologist
  • Kalamazoo, MI
National Provider Identifier
1437540291
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301015893 Issued in MI
Practice address
1919 Stearns Ave
Kalamazoo, MI 49008
Phone
(269) 224-1545
Fax
(269) 312-8972
NPI assigned
Feb 13, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X MI
Clinical Psychologist 103TC0700X 6301015893 MI Primary

Addresses

Primary practice location

1919 Stearns Ave
Kalamazoo, MI 49008

Mailing address

4224 Beechmount Ave
Portage, MI 49024-9520
Phone (269) 267-4758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151203002615 MI Practitioner - Clinical Psychologist 0042510620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Western Michigan Un Homer Stryker School of Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rinehart Institute PLLCGroup PAC ID 1254808777, 6 clinicians

Practice addresses (Care Compare)

5400 Holiday Ter
Suite DB
Kalamazoo, MI 49009-2110
Phone (269) 381-8191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301015893MIMDPsychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1437540291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 BEECHMOUNT AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490249520",
            "telephone_number": "269-267-4758",
            "fax_number": "269-312-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 STEARNS AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49008",
            "telephone_number": "269-224-1545",
            "fax_number": "269-312-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-13",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.