Individual provider Active NPI

Jason Troy Fitzgerald, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Crown Point, IN
National Provider Identifier
1851372346
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
01076416A Issued in IN
Practice address
12750 St Francis Dr Ste 320
Crown Point, IN 46307-0264
Phone
(219) 662-0077
Fax
(219) 662-9496
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01076416A IN
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 11738 MT
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X DR.0056684 CO
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 01076416A IN Primary

Addresses

Primary practice location

12750 St Francis Dr Ste 320
Crown Point, IN 46307-0264

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

2222 N Nevada Ave Ste 5011
Colorado Springs, CO 80907-6819
Phone (720) 321-8680

Other practice location 2

2222 N Nevada Ave Ste 5011
Colorado Springs, CO 80907-6819
Phone (720) 321-8680

Other practice location 3

1201 S Main St
Crown Point, IN 46307-8481
Phone (219) 738-2100

Other identifiers 1

IdentifierTypeStateIssuer
201347360MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfitzgerald383968@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160309000618 IN Practitioner - Thoracic SurgeryPractitioner - General Surgery 7719935634 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: General Surgery
Education
University of Washington School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

5454 Hohman Ave
Hammond, IN 46320-1931
Phone (219) 932-2300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)13
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0056684COMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01076416AINMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
11738MTMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Jan 27, 2018 Accepting new patients
Franciscan Physician Network CurrentSince Jan 27, 2018 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Cardiac Surgery Associates SC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

12750 Saint Francis Dr
Ste 320
Crown Point, IN 46307
Phone (219) 662-0077

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 5

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 4

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1851372346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 ST FRANCIS DR STE 320",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463070264",
            "telephone_number": "219-662-0077",
            "fax_number": "219-662-9496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 N Nevada Ave Ste 5011",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076819",
            "country_code": "US",
            "telephone_number": "720-321-8680",
            "fax_number": "720-321-8681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 N Nevada Ave Ste 5011",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076819",
            "country_code": "US",
            "telephone_number": "720-321-8680",
            "fax_number": "720-321-8681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 S Main St",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463078481",
            "country_code": "US",
            "telephone_number": "219-738-2100",
            "fax_number": "219-681-6867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "JASON",
        "middle_name": "TROY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01076416A",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MT",
            "license": "11738",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CO",
            "license": "DR.0056684",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01076416A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201347360",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfitzgerald383968@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1201 S Main St",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463078481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.