Matthew Shane Fontenot, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

024987 Issued in LA

Practice address

1214 Coolidge Blvd
Lafayette, LA 70503-2621

Phone

(337) 289-7927

Fax

(337) 289-7935

NPI assigned

Mar 10, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfontenot1443402@direct.ochsner.org

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.

• Ambassador Physician Services LLC

  • Hospitalist Physician
  • Lafayette, LA
  • NPI 1134237068
  Medicare reassignment NPD
• Coolidge Physician Services LLC

  • Hospitalist Physician
  • Lafayette, LA
  • NPI 1609298843
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1013985530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53092",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705053092",
            "telephone_number": "337-289-8978",
            "fax_number": "337-289-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "337-289-7927",
            "fax_number": "337-289-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "MATTHEW",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "024987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Gauthier Fontenot, RD,LDN,CDE, MS
• Madeline Fontenot, LPC
• Madisen E Fontenot
• Mark Gabriel Fontenot, DDS
• Mary Alden Fontenot, CRNA
• Neil Fontenot
• Penni Fontenot
• Tamera L Fontenot, NP
• Tanya Fontenot
• Tara Fontenot

• Nephrology Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Nephrology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; 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.

Verify at the official NPI Registry.