NPIMap

Individual provider Active NPI

Kevin M Fitzgerald, MD

  • Family Medicine Physician
  • Onalaska, WI
National Provider Identifier
1730179243
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37997 Issued in WI
Practice address
191 Theatre Rd
Onalaska, WI 54650-8679
Phone
(608) 392-5001
Fax
(608) 392-5790
NPI assigned
Oct 26, 2005
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37997 WI Primary

Addresses

Primary practice location

191 Theatre Rd
Onalaska, WI 54650-8679

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (608) 785-0940

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kfitzgerald25975@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040709001378 WI Practitioner - Family Practice 5698753291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

191 Theater Rd
Onalaska, WI 54650-8679
Phone (608) 392-5000

800 E Blackhawk Ave
Prairie Du Chien, WI 53821-1698
Phone (608) 326-0808

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37997WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Jan 1, 2004 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Jan 1, 2004 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. Past Accepting new patients

Locations

800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951

191 Theater Rd
Onalaska, WI 54650
Phone (608) 392-5000

705 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 357-2000

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

310 W Main St
Sparta, WI 54656
Phone (608) 269-1700

Interoperability endpoints

  • Direct secure messaging: kfitzgerald25975@ehrdirect.mayoclinicmsg.org

Ownership & related parties

All facility ownership & control disclosures 17

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mayo Clinic Health System in Eau ClaireEau Claire, WI, CCN 520070 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Southwest Wisconsin Region IncLa Crosse, WI, CCN 520004 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System - SpartaSparta, WI, CCN 521305 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Red CedarMenomonie, WI, CCN 521340 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-NorthlandBarron, WI, CCN 521315 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-OakridgeOsseo, WI, CCN 521302 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Chippewa ValleyBloomer, WI, CCN 521314 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Red CedarMenomonie, WI, CCN 52Z340 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-NorthlandBarron, WI, CCN 52Z315 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-OakridgeOsseo, WI, CCN 52Z302 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Chippewa ValleyBloomer, WI, CCN 52Z314 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System- SpartaSparta, WI, CCN 52Z305 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System in Eau ClaireEau Claire, WI, CCN 527138 Home health agency Corporate Director Jan 1, 2025
Mayo Clinic Health System - SpartaSparta, WI, CCN 523998 Rural health clinic Corporate Director Jan 1, 2025
Mayo Clinic Health System-Southwest Wisconsin Region IncArcadia, WI, CCN 528601 Rural health clinic Corporate Director Jan 1, 2025
Mayo Clinic Health System - Prairie Du ChienPrairie Du Chien, WI, CCN 528625 Rural health clinic Corporate Director Jan 1, 2025
Mayo Clinic Health System - Oakridge in MondoviMondovi, WI, CCN 528627 Rural health clinic Corporate Director Jan 1, 2025

Owned or controlled facilities with NPI records 17

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 17

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1730179243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 THEATRE RD",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508679",
            "telephone_number": "608-392-5001",
            "fax_number": "608-392-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfitzgerald25975@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "191 Theatre Rd",
            "city": "Onalaska",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546508679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

Verify at the official NPI Registry.