Individual provider Active NPI

Colleen Fitzgerald, MD

  • Family Medicine Physician
  • Phillipsburg, NJ
National Provider Identifier
1861810251
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME142771 Issued in FL
Practice address
755 Memorial Pkwy
Ste 300
Phillipsburg, NJ 08865-2748
Phone
(908) 454-6303
Fax
(908) 454-2289
NPI assigned
Apr 2, 2014
Last updated
Nov 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME142771 FL Primary

Addresses

Primary practice location

755 Memorial Pkwy
Ste 300
Phillipsburg, NJ 08865-2748

Mailing address

755 Memorial Pkwy
Ste 300
Phillipsburg, NJ 08865-2748
Phone (908) 454-6303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20171003006003 PA Practitioner - Family Practice 6406129311 Reassigns benefits to 1 organization
I20180108001156 NC Practitioner - Family Practice 6406129311
I20191231000387 FL Practitioner - Hospitalist 6406129311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME142771FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Nov 14, 2017 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Aug 17, 2017 Accepting new patients
St. Luke's Physician Group, Inc. Family Medicine Current Accepting new patients
St Luke's Physician Group Inc Family Medicine CurrentSince Aug 17, 2017 Accepting new patients
Florida Hospital Healthcare Partners, Inc CurrentSince Jan 6, 2019 Accepting new patients

Locations

301 Memorial Medical Pkwy
Daytona Beach, FL 32117
Phone (386) 231-3906

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

628 E 12th St
Washington, NC 27889
Phone (252) 975-4100

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cfitzgerald57613@adventhealth.direct-ci.com

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

Hospital & facility affiliations 1

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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1861810251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MEMORIAL PKWY",
            "address_2": "STE 300",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652748",
            "telephone_number": "908-454-6303",
            "fax_number": "908-454-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MEMORIAL PKWY",
            "address_2": "STE 300",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652748",
            "telephone_number": "908-454-6303",
            "fax_number": "908-454-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "COLLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME142771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

Verify at the official NPI Registry.