Individual provider Active NPI

Frederick Fisher, M.D.

  • Surgery Physician
  • Voorhees, NJ
National Provider Identifier
1639171663
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA06651400 Issued in NJ
Practice address
502 Centennial Blvd
Suite 7
Voorhees, NJ 08043-9544
Phone
(856) 596-7440
Fax
(856) 596-6723
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA06651400 NJ Primary

Addresses

Primary practice location

502 Centennial Blvd
Suite 7
Voorhees, NJ 08043-9544

Mailing address

502 Centennial Blvd
Suite 7
Voorhees, NJ 08043-9544
Phone (856) 596-7440

Other identifiers 1

IdentifierTypeStateIssuer
7464401MedicaidNJ

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
I20240606000717 FL Order and Referring Only - Vascular SurgeryPractitioner - Vascular Surgery 6709872773

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1639171663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 CENTENNIAL BLVD",
            "address_2": "SUITE 7",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439544",
            "telephone_number": "856-596-7440",
            "fax_number": "856-596-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 CENTENNIAL BLVD",
            "address_2": "SUITE 7",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439544",
            "telephone_number": "856-596-7440",
            "fax_number": "856-596-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "FREDERICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA06651400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7464401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.