Active NPI
Donna M. Fitzgerald, P.A.
- Medical Physician Assistant
- Boston, MA
National Provider Identifier
1487659330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2147
- Practice address
- 330 Brookline Avenue
7 Feldberg Outpatient
Boston, MA 02215-5400 - Phone
- (617) 667-6841
- Fax
- (617) 667-7978
- NPI assigned
- Jun 16, 2005
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2147 | MA | Primary |
Addresses
Primary practice location
330 Brookline Avenue
7 Feldberg Outpatient
Boston, MA 02215-5400
Mailing address
330 Brookline Ave
Feldberg 7 Outpatient
Boston, MA 02215-5400
Phone (617) 667-6841
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 222594672 | Other | NH | GREATWEST HEALTHCARE |
| 2139341 | Other | NH | CIGNA |
| 222594672 | Other | NH | TRICARE |
| 30332576 | Medicaid | NH | |
| 222594672 | Other | NH | HEALTHCARE VALUE MANAGE |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2147 | MA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487659330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVE",
"address_2": "FELDBERG 7 OUTPATIENT",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-667-6841",
"fax_number": "617-667-7978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVENUE",
"address_2": "7 FELDBERG OUTPATIENT",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-667-6841",
"fax_number": "617-667-7978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "DONNA",
"middle_name": "M.",
"name_prefix": "Ms.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MA",
"license": "2147",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREATWEST HEALTHCARE",
"identifier": "222594672",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2139341",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "222594672",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30332576",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE VALUE MANAGE",
"identifier": "222594672",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.