Mary G Witkowski, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12505 Issued in NC

Practice address

3007 Town Center Dr Ste 100
Fayetteville, NC 28306-3663

Phone

(518) 292-6000

Fax

(518) 292-6005

NPI assigned

Aug 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.09 of 100Reported as group

Quality

65.78

Improvement activities

40

Cost

76.37

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mwitkowski788739@direct.trinity-health.org

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.

• Fastmed P.C.

  • Family Medicine Physician
  • Durham, NC
  • NPI 1629841788
  Medicare reassignment Care Compare group
• Fastmed Primary Care, P.C.

  • Family Medicine Physician
  • Fayetteville, NC
  • NPI 1912774423
  NPD (past)
• Fastmed Urgent Care PC

  • General Practice Physician
  • Charlotte, NC
  • NPI 1154624831
  NPD (past)
• Burdett Orthopedics, PC

  • Orthopaedic Surgery Physician
  • Troy, NY
  • NPI 1801816327
  NPD (past)

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1467007377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 TOWN CENTER DR STE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283063663",
            "telephone_number": "518-292-6000",
            "fax_number": "518-292-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 TOWN CENTER DR STE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283063663",
            "telephone_number": "518-292-6000",
            "fax_number": "518-292-6005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2231 Burdett Ave Ste 160",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802453",
            "country_code": "US",
            "telephone_number": "518-292-6200",
            "fax_number": "518-292-6228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITKOWSKI",
        "first_name": "MARY",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023809",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara V. Wise, M.D.
• Elizabeth Ann Marie Wise, PA-C
• Larry Dale Withers, MD
• Within Your Doors Home Care
• Lisa Withrow
• Donna Lee Witt, LCAS-A
• Laressa Marie Witt, LCSWA
• Rachel Megan Wittig, LCMHCA
• Tyler Joann Wittwer
• Wofford and Williams Inc

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.