Active NPI
Virginia Fitzgerald, MD
- Pediatrics Physician
- South Boston, MA
National Provider Identifier
1487628087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 54611
- Practice address
- 409 W Broadway
South Boston, MA 02127-2245 - Phone
- (617) 269-7500
- Fax
- (617) 464-7512
- NPI assigned
- Feb 13, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 54611 | MA | Primary |
Addresses
Primary practice location
409 W Broadway
South Boston, MA 02127-2245
Mailing address
409 W Broadway
South Boston, MA 02127-2245
Phone (617) 269-7500
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000008295 | Other | MA | BMC HEALTHNET |
| 202216BMC | Other | MA | HARVARD PILGRIM |
| 054611 | Other | MA | TUFTS HEALTH PLAN |
| B10338103 | Other | MA | CIGNA |
| 202216BMC | Other | MD | FIRST SENIORITY |
| 0018245 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| J31632 | Other | MA | BLUE CROSS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322697600000",
"number": "1487628087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 W BROADWAY",
"city": "SOUTH BOSTON",
"state": "MA",
"postal_code": "021272245",
"telephone_number": "617-269-7500",
"fax_number": "617-464-7512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 W BROADWAY",
"city": "SOUTH BOSTON",
"state": "MA",
"postal_code": "021272245",
"telephone_number": "617-269-7500",
"fax_number": "617-464-7512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "VIRGINIA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-13",
"last_updated": "2011-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "54611",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC HEALTHNET",
"identifier": "00000008295",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "202216BMC",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "054611",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "B10338103",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST SENIORITY",
"identifier": "202216BMC",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0018245",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J31632",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.