Charles J Fetterman, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

214954 Issued in NY

Practice address

70 Professional Parkway
Lockport, NY 14094-5366

Phone

(716) 434-7505

Fax

(716) 439-9084

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Ophthalmology

Education

State University of New York at Buffalo School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charles J Fetterman MD PCGroup PAC ID 8527038652, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

100

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cfetterman@fetterman.intellechartdirect.net

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.

• Charles J Fetterman MD PC

  • Ophthalmology Physician
  • Lockport, NY
  • NPI 1316004013
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1922038785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 PROFESSIONAL PARKWAY",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945366",
            "telephone_number": "716-434-7505",
            "fax_number": "716-439-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PROFESSIONAL PARKWAY",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945366",
            "telephone_number": "716-434-7505",
            "fax_number": "716-439-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTERMAN",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-03-28",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "214954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02246591",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cfetterman@fetterman.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "70 Professional Parkway",
            "city": "Lockport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "140945366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Farzana Habib
• Vivian Kudgus Fasula, M.D.
• Hany Antoun Fattouch, M.D.
• James Edmund Ferington, D.D.S.
• Sally Ferrigno, LMSW
• Meghann Elizabeth Fiegl, D.C.
• Julia Fierle, LCSW
• Zach Finney, RD
• Megan Hart Fitzgerald, LMHC
• Margaret Diane Flannery, LMSW

• Ophthalmology Physician in Lockport, NY
• Providers in Lockport, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.