Individual provider Active NPI

Lisa M Fitzgibbons, MD

  • Pediatrics Physician
  • Haverhill, MA
National Provider Identifier
1467517250
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
203800 Issued in MA
Practice address
1 Parkway
Haverhill, MA 01830
Phone
(978) 521-3230
Fax
(978) 521-3256
NPI assigned
Dec 22, 2006
Last updated
Jul 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 11591 NH
Pediatrics Physician 208000000X 203800 MA Primary

Addresses

Primary practice location

1 Parkway
Haverhill, MA 01830

Mailing address

1 Parkway
Haverhill, MA 01830-6278
Phone (978) 521-3230

Other practice location 1

23 Stiles Rd
Suite 210
Salem, NH 03079
Phone (603) 893-1521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20180416000287 MA Practitioner - Pediatric Medicine 1355604828 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203800MAMDPediatrics Physician
11591NHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc CurrentSince Mar 4, 2018 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Pediatrics CurrentSince Jan 1, 2026 Accepting new patients
Pentucket Medical Associates, LLC Pediatrics Current Accepting new patients
Mass General Brigham Community Physicians Inc. Pediatrics CurrentSince Mar 4, 2018 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

1 Parkway
Haverhill, MA 01830
Phone (978) 521-3210

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

Interoperability endpoints

  • Direct secure messaging: fitzgibbons.lisa.pma@direct.partners.masshiway.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1467517250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARKWAY",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306278",
            "telephone_number": "978-521-3230",
            "fax_number": "978-521-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARKWAY",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "01830",
            "telephone_number": "978-521-3230",
            "fax_number": "978-521-3256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Stiles Rd",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "NH",
            "postal_code": "03079",
            "country_code": "US",
            "telephone_number": "603-893-1521",
            "fax_number": "603-894-5529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGIBBONS",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "11591",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "203800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.