Individual provider Active NPI

Alyssa Kay Fitzsimmons, APN

  • Acute Care Nurse Practitioner
  • Midland Park, NJ
National Provider Identifier
1528773660
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ01429500 Issued in NJ
Practice address
4 Godwin Ave Ste 1
Midland Park, NJ 07432-1973
Phone
(201) 444-7070
Fax
(201) 444-7228
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 26NJ01429500 NJ Primary

Addresses

Primary practice location

4 Godwin Ave Ste 1
Midland Park, NJ 07432-1973

Mailing address

775 Macopin Rd
West Milford, NJ 07480-2626
Phone (973) 392-1352

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230306002896 NJ Practitioner - Nurse Practitioner 2567835978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology Group PAGroup PAC ID 7214908102, 8 clinicians

Practice addresses (Care Compare)

4 Godwin Ave
Midland Park, NJ 07432-1980
Phone 2014447070216

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.75 of 100Reported as group
Quality
95
Improvement activities
40
Cost
59.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Group PA Single Specialty CurrentSince Mar 9, 2023 Accepting new patients

Locations

4 Godwin Ave
Midland Park, NJ 07432
Phone (201) 444-7070

4 Godwin Ave
Ste 1
Midland Park, NJ 07432
Phone (201) 444-7070

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1528773660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 MACOPIN RD",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "074802626",
            "telephone_number": "973-392-1352",
            "fax_number": "201-444-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GODWIN AVE STE 1",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321973",
            "telephone_number": "201-444-7070",
            "fax_number": "201-444-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMMONS",
        "first_name": "ALYSSA",
        "middle_name": "KAY",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ01429500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland Park, NJ

Sources for this page

Verify at the official NPI Registry.