Individual provider Active NPI

Lisa Fitzgerald, AGACNP-BC

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1790144475
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F430945 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-7555
NPI assigned
Feb 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F430945 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

1275 York Ave
New York, NY 10065-6007

Other practice location 1

301 E 17th St
New York, NY 10003-3804
Phone (212) 598-6205

Other practice location 2

301 E 17th St
New York, NY 10003-3804
Phone (212) 598-6205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180319001923 NY Practitioner - Nurse Practitioner 9234422007 Reassigns benefits to 8 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F430945NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Clinical Physiology Group CurrentSince Apr 8, 2018 Accepting new patients
Memorial Cardiopulmonary Group CurrentSince Apr 8, 2018 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince Mar 1, 2020 Accepting new patients
Memorial Anesthesiology Group CurrentSince Jan 17, 2018 Accepting new patients
Memorial Hematology Lymphoma Group Current Accepting new patients
Memorial Neurology Group CurrentSince Apr 8, 2018 Accepting new patients
Memorial Infectious Disease Group CurrentSince Apr 8, 2018 Accepting new patients
Mskcc Clinical Practice Plan CurrentSince Apr 8, 2018 Accepting new patients
Memorial Pulmonary Function Group CurrentSince Apr 8, 2018 Accepting new patients
Mskcc Clinical Practice Plan CurrentSince Apr 8, 2018 Accepting new patients

Locations

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Interoperability endpoints

  • Direct secure messaging: lfitzgerald30912@nyumc.direct-ci.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1790144475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-7555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E 17th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100033804",
            "country_code": "US",
            "telephone_number": "212-598-6205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 E 17th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100033804",
            "country_code": "US",
            "telephone_number": "212-598-6205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "LISA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F430945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.