Susan Kathleen Fitzgerald, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101057533 Issued in VA

Practice address

8100 Ashton Ave
Ste. 207
Manassas, VA 20109-5622

Phone

(703) 334-5801

Fax

(703) 334-5805

NPI assigned

Sep 21, 2005

Reactivated

Sep 26, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2013 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• North Arlington Family Practice, PC

  dba Ashton Avenue Family Medicine

  • Family Medicine Physician
  • Manassas, VA
  • NPI 1083896476
  NPD (past) Authorized official
• Gainesville Family Practice, P.C.

  • Family Medicine Physician
  • Gainesville, VA
  • NPI 1871589770
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1730175209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 ASHTON AVE",
            "address_2": "STE. 207",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095622",
            "telephone_number": "703-334-5801",
            "fax_number": "703-334-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ASHTON AVE",
            "address_2": "STE. 207",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095622",
            "telephone_number": "703-334-5801",
            "fax_number": "703-334-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "SUSAN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2011-01-06",
        "deactivation_date": "2005-09-21",
        "reactivation_date": "2005-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101057533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2199062",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM  BC/BS",
            "identifier": "309288",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO/HMO",
            "identifier": "5649863",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7049008",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheri Finocchiaro, BSPT
• Cameryn Fireline, M.ED.
• First Choice Medical Ride,LLC
• Lauren Joan Fisher, PSYD
• Meghan Fisher
• Laura Fitzpatrick
• Lynne Flagg, M.D
• Karyn Flannagan, PSYD
• Candace Fleming, M. ED., LPC
• Angela Wilson Fletcher, CRNA

• Family Medicine Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.