DR. DOUGLAS STEWART FITZWATER (MD) – Pediatrics Physician, NPI 1619967106
Pediatrics Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
878 PEDIATRIC MEDICINE in MO
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Provider Addresses for DR. DOUGLAS STEWART FITZWATER (MD)
Missouri Delta Medical Center, 1008, North Main Street, Sikeston, Scott County, Missouri, 63801, United States
SIKESTON, MO 638015044
Phone: (573) 472-7406
Fax: (573) 472-7475
Type: Mailing
204, East 3rd Street, Portageville, New Madrid County, Missouri, 63873, United States
PORTAGEVILLE, MO 638731402
Phone: (573) 379-5467
Fax: (573) 379-5671
Type: Location
615 Main St
New Madrid, MO 638691513
Phone: (573) 748-2546
Fax: (573) 748-2433
Type: Location
1 Childrens Pl
Saint Louis, MO 631101002
Phone: (314) 454-2076
Fax: (314) 747-8953
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $540.
Total Amount is formed as General ($540) + Research ($0) + Ownership ($0) = $540.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($140).
Total Amount
$540
General + Research + Ownership
Payments
23
Total payment records
General Amount
$540
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $140 |
| Novo Nordisk Inc | $114 |
| Phathom Pharmaceuticals, Inc. | $80 |
| Janssen Pharmaceuticals, Inc | $74 |
| Grifols USA, LLC | $38 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-09-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040915000253 | I | Pediatric Medicine | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63801)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Certified Registered Nurse Anesthetist (Crna) | AR | |
| Physician Assistant | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Endocrinology, Internal Medicine | MO | |
| Family Practice | MO | |
| General Surgery | MO |
Reviews
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