Individual provider Active NPI

Ked Fortuzi, MD

  • Pulmonary Disease Physician
  • West Nyack, NY
National Provider Identifier
1790346161
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
334942 Issued in NY
Practice address
2 Centerock Rd
West Nyack, NY 10994-2215
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
Jun 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 334942 NY Primary

Addresses

Primary practice location

2 Centerock Rd
West Nyack, NY 10994-2215

Mailing address

PO Box 411730
Boston, MA 02241-1730
Phone (845) 703-6999

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250731000650 NY Practitioner - Pulmonary Disease 1153839352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crystal Run Healthcare Physicians LLPGroup PAC ID 6901792696, 366 clinicians

Practice addresses (Care Compare)

300 Crystal Run Rd
Middletown, NY 10941-4069
Phone (845) 692-6999

Hospital & facility affiliations

  • Nyack Hospital Hospital, Nyack, NY, CCN 330104
  • Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Run Healthcare Physicians LLP CurrentSince Aug 4, 2025 Accepting new patients
Crystal Run Healthcare Physicians LLP CurrentSince Aug 4, 2025 Accepting new patients

Locations

300 Crystal Run Rd
Middletown, NY 10941
Phone (845) 692-6999

855 State Route 17M
Monroe, NY 10950
Phone (845) 615-6999

2 Centerock Rd
West Nyack, NY 10994
Phone (844) 592-7009

Interoperability endpoints

  • Direct secure messaging: kfortuzi229732@direct.optum.com

Organizations & group practices 2

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 2

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1790346161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411730",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022411730",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CENTEROCK RD",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942215",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUZI",
        "first_name": "KED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-26",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "334942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

Verify at the official NPI Registry.