MEDICARE: DR. JAMES B. FITZGERALD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	170760	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	300080526	OTHER	NY	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1609206	OTHER	NY	INDEPENDENT HEALTH
2	000528594005	OTHER	NY	BCBS
3	00026373106	OTHER	NY	UNIVERA HEALTHCARE
5	040426000214	OTHER	NY	FIDELIS CARE OF NEW YORK
6	146163FF	OTHER	NY	PREFERRED CARE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386615987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES B. FITZGERALD MD

Provider Business Mailing Address
First Line	:	3040 AMSDELL RD
Second Line	:
City	:	HAMBURG
State	:	NY
Zip	:	14075-5835
Country	:	US
Telephone Number	:	716-649-9000
Fax Number	:	716-649-9005

Provider Business Practice Location Address
First Line	:	565 ABBOTT RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14220-2039
Country	:	US
Telephone Number	:	716-826-7000
Fax Number	:	716-649-9005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	09/16/2013

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