NPIMap

Individual provider Active NPI

Ryan H. Fitzwater, D.O.

  • Urology Physician
  • Charleston, WV
National Provider Identifier
1770524977
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2253 Issued in WV
Practice address
1201 Washington St E
Suite 105
Charleston, WV 25301-1834
Phone
(304) 388-1965
Fax
(304) 388-1969
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2253 WV
Physician Assistant 363A00000X
Urology Physician 208800000X 2253 WV Primary

Addresses

Primary practice location

1201 Washington St E
Suite 105
Charleston, WV 25301-1834

Mailing address

415 Morris St
Suite 304
Charleston, WV 25301-1842
Phone (304) 388-7782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20090114000229 WV Practitioner - UrologyPractitioner - Emergency Medicine 2769407683 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charleston Area Medical Center IncGroup PAC ID 3375441637, 969 clinicians

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • Boone Memorial Hospital Hospital, Madison, WV, CCN 511313
  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029
  • Camc Plateau Medical Center, Inc Hospital, Oak Hill, WV, CCN 511317

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
767WVMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Dec 13, 2015 Accepting new patients
Boone Memorial Hospital, Inc CurrentSince May 1, 2023 Accepting new patients
Boone Memorial Hospital, Inc Physician Assistant Current Accepting new patients
Boone Memorial Hospital, Inc Current Accepting new patients
Charleston Area Medical Center Inc CurrentSince Dec 13, 2015 Accepting new patients
Boone Memorial Hospital, Inc CurrentSince May 1, 2023 Accepting new patients
Boone Memorial Hospital, Inc Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Epmg of Virginia P C Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Boone Memorial Hospital, Inc Past Accepting new patients
Boone Memorial Hospital, Inc Past Accepting new patients

Locations

415 Morris St
Ste 304
Charleston, WV 25301

415 Morris St
Ste 309
Charleston, WV 25301
Phone (304) 348-3290

3100 Maccorkle Ave SE
Ste 203
Charleston, WV 25304
Phone (304) 345-8820

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1220 Lee St E
Ste 100
Charleston, WV 25301
Phone (304) 388-1965

6952 Coal River Rd
#C
Comfort, WV 25049
Phone (304) 307-3116

300 4th St
Danville, WV 25053
Phone (304) 307-6201

3703 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 757-2273

701 Madison Ave
Madison, WV 25130
Phone (304) 369-1230

660 S Main St
#A
Madison, WV 25130
Phone (304) 369-1230

716 Madison Ave
Madison, WV 25130
Phone (304) 369-1230

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/boonemh-81155461

Organizations & group practices 12

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1770524977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST",
            "address_2": "SUITE 304",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011842",
            "telephone_number": "304-388-7782",
            "fax_number": "304-388-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 WASHINGTON ST E",
            "address_2": "SUITE 105",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011834",
            "telephone_number": "304-388-1965",
            "fax_number": "304-388-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZWATER",
        "first_name": "RYAN",
        "middle_name": "H.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WV",
            "license": "2253",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WV",
            "license": "2253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.