MEDICARE: DR. PATRICIA G FITZPATRICK M.D.

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	207RC0000X	Cardiovascular Disease Physician	143633	NY
2	207RI0011X	Interventional Cardiology Physician	143633	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	060047207	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0001084044	OTHER	UNITED HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	6890	OTHER	BCBS
4	POO10143633	OTHER	EXCELLUS
5	301133	OTHER	WELLCARE
6	005251451	OTHER	HEALTH NOW (PARNALL)
7	4285979	OTHER	AETNA
8	005251451	OTHER	COMM BLUE/BCBSWNY
10	2197784	OTHER	GHI
11	7701216	OTHER	MVP
12	MDC187	OTHER	PREFERRED CARE
13	PO10143633	OTHER	GRIPA
14	RC60143633	OTHER	RCIPA
15	000525145003	OTHER	HEALTH NOW (LINDEN)

General Provider Information

NPI Number	:	1801863691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA G FITZPATRICK M.D.

Provider Business Mailing Address
First Line	:	30 HAGEN DR
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2658
Country	:	US
Telephone Number	:	585-338-2700
Fax Number	:	585-242-9663

Provider Business Practice Location Address
First Line	:	30 HAGEN DR
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2658
Country	:	US
Telephone Number	:	585-338-2700
Fax Number	:	585-242-9663

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

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	04/15/2015

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