Michael Warren Fountain, D.O.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

OS10783 Issued in FL

Practice address

1210 Waterman Way
Tavares, FL 32778-5229

Phone

(352) 343-2364

Fax

(352) 253-0022

NPI assigned

Oct 19, 2008

Last updated

Sep 9, 2015By the provider in NPPES

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 FL

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

Specialty

Urology

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• FL PPO
• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mfountain58579@adventhealth.direct-ci.com

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Florida Hospital Waterman Inc

  dba AdventHealth Waterman

  • General Acute Care Hospital
  • Tavares, FL
  • NPI 1821019571

  Corporate Director

  CMS ownership
• Florida Hospital Waterman Inc

  dba AdventHealth Waterman

  • Rehabilitation Hospital Unit
  • Ormond Beach, FL
  • NPI 1851940035

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Hospital Healthcare Partners, Inc

  • Internal Medicine Physician
  • Daytona Beach, FL
  • NPI 1780100529
  Medicare reassignment Care Compare group NPD
• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  Medicare reassignment Care Compare group NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando Outreach Laboratory

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation
• Florida Hospital Waterman Inc

  dba AdventHealth Waterman

  • General Acute Care Hospital
  • Tavares, FL
  • NPI 1821019571
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• South Lake Hospital, Inc.

  dba Orlando Health South Lake Hospital

  • General Acute Care Hospital
  • Clermont, FL
  • NPI 1336221019
  Care Compare affiliation

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

{
    "created_epoch": "1224374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1023260205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785229",
            "telephone_number": "352-343-2364",
            "fax_number": "352-253-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785229",
            "telephone_number": "352-343-2364",
            "fax_number": "352-253-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "MICHAEL",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-19",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "OS10783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Joan Forrester, D.M.D.
• Marie Fors, LMFT
• Catherine Forsyth
• Brynn Elizabeth Forsythe, BSN
• Fountain Inn Nursing & Rehabilitation Center Inc (AdventHealth Care Center Waterman)
• Moises Fraifeld, MD
• Janith Frances
• Lula M Frazier
• Patricia Ann Frazier, RD LD
• Patrice R Frederick, MD

• Urology Physician in Tavares, FL
• Providers in Tavares, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.