Individual provider Active NPI

Laura Paul Fite, M.D.

  • Dermatology Physician
  • Longview, TX
National Provider Identifier
1861750416
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
P8354 Issued in TX
Practice address
3535 N Fourth St Ste 400
Longview, TX 75605-0038
Phone
(903) 757-3881
Fax
(903) 757-5948
NPI assigned
May 1, 2012
Last updated
Mar 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X P8354 TX Primary

Addresses

Primary practice location

3535 N Fourth St Ste 400
Longview, TX 75605-0038

Mailing address

3535 N Fourth St Ste 400
Longview, TX 75605-0038
Phone (903) 757-3881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140117001305 TX Practitioner - Dermatology 9234367343 Reassigns benefits to 1 organization
I20170809003824 VA Practitioner - Dermatology 9234367343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at Houston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wallis Dermatology Associates PLLCGroup PAC ID 0749440188, 11 clinicians

Practice addresses (Care Compare)

3535 N 4TH St
Suite 400
Longview, TX 75605-0036
Phone (903) 757-3881

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision124
Removal of tissue1-10
Removal of skin lesions1209
Removal or shaving of skin growth36
Skin biopsy228

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Dermatology, P.C. CurrentSince Jul 5, 2017 Accepting new patients
Wallis Dermatology Associates PLLC Dermatology CurrentSince Jul 16, 2018 Accepting new patients

Locations

3535 N Fourth St
Ste 400
Longview, TX 75605
Phone (903) 757-3881

6 Doctor Cir
Longview, TX 75605
Phone (903) 592-1664

1900 S Washington Ave
Ste E
Marshall, TX 75670
Phone (903) 503-7330

1600 N Coalter St
Ste 19
Staunton, VA 24401
Phone (540) 885-4500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1861750416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 N FOURTH ST STE 400",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756050038",
            "telephone_number": "903-757-3881",
            "fax_number": "903-757-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 N FOURTH ST STE 400",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756050038",
            "telephone_number": "903-757-3881",
            "fax_number": "903-757-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITE",
        "first_name": "LAURA",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P8354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.