Individual provider Active NPI

Jessica Fugitt, DO

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1619417227
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS15119 Issued in FL
Practice address
703 N Flamingo Rd
Pembroke Pines, FL 33028-1006
Phone
(954) 844-1300
NPI assigned
Mar 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS15119 FL Primary

Addresses

Primary practice location

703 N Flamingo Rd
Pembroke Pines, FL 33028-1006

Mailing address

703 N Flamingo Rd
Pembroke Pines, FL 33028-1006
Phone (954) 844-1300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfugitt193231@MHSDIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190122003208 FL Practitioner - Internal Medicine 7214274737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastside Hospitalists IncGroup PAC ID 9436157831, 179 clinicians

Practice addresses (Care Compare)

7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone (954) 962-9650

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastside Hospitalists Inc CurrentSince Aug 1, 2018 Accepting new patients
QMC LLC PastSince Feb 1, 2021 Accepting new patients

Locations

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

7800 Sheridan St
Pembroke Pines, FL 33024
Phone (954) 962-9650

703 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 436-5000

Interoperability endpoints

  • Direct secure messaging: jfugitt193231@mhsdirect.net

Organizations & group practices 2

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": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1619417227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281006",
            "telephone_number": "954-844-1300",
            "fax_number": "954-844-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281006",
            "telephone_number": "954-844-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGITT",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-01",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfugitt193231@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "7800 Sheridan St",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330242536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.