NPIMap

Individual provider Active NPI

Kenneth J Fitzpatrick, M.D.

  • Urology Physician
  • Devon, PA
National Provider Identifier
1669407748
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD056906L Issued in PA
Practice address
640 Clovelly LN
Devon, PA 19333-1847
Phone
(484) 431-5718
Fax
(484) 480-2987
NPI assigned
Jul 11, 2006
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 01088523A IN
Urology Physician 208800000X MD056906L PA Primary

Addresses

Primary practice location

640 Clovelly LN
Devon, PA 19333-1847

Mailing address

640 Clovelly LN
Devon, PA 19333
Phone (484) 431-5718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070917000126 PA Practitioner - Urology 1759318819 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

620 Howard Ave
Altoona, PA 16601-4804
Phone (814) 889-2328

815 Sir Thomas CT
Suite 200
Harrisburg, PA 17109-4839
Phone (717) 724-0720

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01088523AINMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC CurrentSince Aug 23, 2022 Accepting new patients
University of Pittsburgh Physicians CurrentSince Sep 6, 2021 Accepting new patients
Pinnacle Health Medical Services CurrentSince May 2, 2023 Accepting new patients
University of Pittsburgh Physicians Urology CurrentSince Sep 6, 2021 Accepting new patients
Gslpg, Inc CurrentSince Jun 1, 2022 Accepting new patients
Delta Medix PC CurrentSince Sep 10, 2019 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Aug 23, 2022 Accepting new patients
Pinnacle Health Medical Services CurrentSince May 2, 2023 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Urology Center of Chester County P C Urology Past Accepting new patients
Alliance Physician Services, PC Urology Past Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

815 Sir Thomas Ct
Ste 200
Harrisburg, PA 17109
Phone (717) 724-0720

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1111 Franklin St
Ste 410
Johnstown, PA 15905
Phone (814) 534-7800

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

300 Halket St
Ste 5200
Pittsburgh, PA 15213
Phone (412) 641-7850

300 Lackawanna Ave
Unit 200
Scranton, PA 18503
Phone (570) 342-7864

5 Morgan Hwy
Ste 7
Scranton, PA 18508
Phone (570) 342-7864

700 High St
Williamsport, PA 17701
Phone (570) 321-2000

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 11

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1669407748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 CLOVELLY LN",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "19333",
            "telephone_number": "484-431-5718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 CLOVELLY LN",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331847",
            "telephone_number": "484-431-5718",
            "fax_number": "484-480-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01088523A",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD056906L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devon, PA

Sources for this page

Verify at the official NPI Registry.