Active NPI
Geofrey Adam Fortier, PA-C
- Physician Assistant
National Provider Identifier
1871365510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17066
- Practice address
- 52 MDG
Unit 3690
Apo, AE 09126 - Phone
- (314) 452-8333
- NPI assigned
- Oct 26, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17066 | TX | Primary |
Addresses
Primary practice location
52 MDG
Unit 3690
Apo, AE 09126
Mailing address
52 MDG
Unit 3690
Apo, AE 09126
Phone (972) 259-7355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240206004146 | TX | Practitioner - Physician Assistant | 9436592409 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17066 | TX | MD | Physician Assistant |
Interoperability endpoints
- gfortier1281862@direct.sw.org
Organizations & group practices 1
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": "1698278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742774400000",
"number": "1871365510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "52 MDG",
"address_2": "UNIT 3690",
"city": "APO",
"state": "AE",
"postal_code": "09126",
"telephone_number": "972-259-7355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "MIL",
"address_1": "52 MDG",
"address_2": "UNIT 3690",
"city": "APO",
"state": "AE",
"postal_code": "09126",
"telephone_number": "314-452-8333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTIER",
"first_name": "GEOFREY",
"middle_name": "ADAM",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-26",
"last_updated": "2025-03-24",
"certification_date": "2025-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA17066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.