Active NPI
Ray Fontenot, M.D.
- Otolaryngology Physician
- Minot, ND
National Provider Identifier
1003881558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- H1081
- Practice address
- 101 3Rd Ave SW
Minot, ND 58701-3880 - Phone
- (701) 857-5986
- Fax
- (701) 857-5029
- NPI assigned
- Feb 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 17541 | ND | |
| Otolaryngology Physician | 207Y00000X | PT17541 | ND | |
| Otolaryngology Physician | 207Y00000X | H1081 | TX | Primary |
Addresses
Primary practice location
101 3Rd Ave SW
Minot, ND 58701-3880
Mailing address
101 3Rd Ave SW
Minot, ND 58701-3880
Other practice location 1
2305 37th Ave SW
Minot, ND 58701-7669
Phone (701) 857-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128721103 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17541 | ND | MD | Otolaryngology Physician |
| H1081 | TX | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Texas Ear, Nose & Throat, LLP | Otolaryngology | Current | Accepting new patients |
Locations
740 Hospital Dr
Ste 300
Beaumont, TX 77701
Phone (409) 212-8111
Organizations & group practices 1
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.
-
- Otolaryngology Physician
- Beaumont, TX
- NPI 1962477406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681344000000",
"number": "1003881558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 3RD AVE SW",
"city": "MINOT",
"state": "ND",
"postal_code": "587013880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 3RD AVE SW",
"city": "MINOT",
"state": "ND",
"postal_code": "587013880",
"telephone_number": "701-857-5986",
"fax_number": "701-857-5029"
}
],
"practiceLocations": [
{
"address_1": "2305 37th Ave SW",
"address_purpose": "LOCATION",
"city": "Minot",
"state": "ND",
"postal_code": "587017669",
"country_code": "US",
"telephone_number": "701-857-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FONTENOT",
"first_name": "RAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-20",
"last_updated": "2023-04-13",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "ND",
"license": "17541",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "ND",
"license": "PT17541",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "TX",
"license": "H1081",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128721103",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.