Mr Kevin Barry Fitzgerald, PA-C is a medicare enrolled "Physician Assistant" in Tieton, Washington. His current practice location is
915 Wisconsin Ave, Tieton, Washington. You can reach out to his office (for appointments etc.) via phone at
(509) 673-0044.
Mr Kevin Barry Fitzgerald is licensed to practice in Washington (license number PA60427970) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1548565682.
Provider's Profile
| Full Name | Mr Kevin Barry Fitzgerald |
|---|
| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 915 Wisconsin Ave, Tieton, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1548565682
- Provider Enumeration Date: 01/21/2011
- Last Update Date: 02/27/2020
Medicare PECOS Information:
- PECOS PAC ID: 4284817396
- Enrollment ID: I20110328000638
Medical Identifiers
Medical identifiers for Mr Kevin Barry Fitzgerald such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1548565682 | NPI | - | NPPES |
| 2040154 | Medicaid | WA | |
| 0419110 | Other | WA | LABOR AND INDUSTRIES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | 2104 (Alaska) | Secondary |
| 363A00000X | Physician Assistant | PA60427970 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kevin Barry Fitzgerald is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Kevin Barry Fitzgerald, PA-C
38555 St. John, Cir., Po Box 1068,
Talkeetna, AK 99676
Ph: (907) 733-2704 | Mr Kevin Barry Fitzgerald, PA-C
915 Wisconsin Ave,
Tieton, WA 98947-9802
Ph: (509) 673-0044 |
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