Michael Edwin Fenton, MD
Individual provider Active NPI Diagnostic Radiology Physician · Tamuning, GU
NPI 1033183264 · NPPES record last updated Mar 5, 2026
Key facts
- NPI
- 1033183264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- M-1810 (GU)
- Practice address
- 643 Chalan San Antonio Ste 109
Tamuning, GU 96913-3644 - Phone
- (671) 648-6390
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Other, 1997
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Pacific Radiology Inc a Professional Corporation
Ybl PLLC
Practice addresses (Care Compare)
388 Ypao Rd
Tamuning, GU 96913-3701
Phone (671) 646-8881
643 Chalan San Antonio
Suite 109
Tamuning, GU 96913-3644
Phone 6716486390816
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GU, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141212000276 | GU | Practitioner - Diagnostic Radiology |
2961640602 | Reassigns benefits to 4 organizations |
| I20240529000048 | FL | Practitioner - Diagnostic Radiology | 2961640602 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00022516 | AL | MD | Diagnostic Radiology Physician |
| M-1810 | GU | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Radiology Associates, PLLC | Diagnostic Radiology | Current |
Accepting new patients |
| Ybl PLLC | Diagnostic Radiology | Current |
Accepting new patients |
| Greensboro Radiology, PA | Diagnostic Radiology | Current |
Accepting new patients |
| General Conference Corp of Sda | Current |
Accepting new patients | |
| Takecare Insurance Company Inc. | Current |
Accepting new patients |
Locations
643 Chalan San Antonio
Ste 109
Tamuning, GU 96913
Phone (671) 648-6390
850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552
548 S Marine Corps Dr
Tamuning, GU 96913
Phone (671) 646-5824
1331 N Elm St
Ste 200
Greensboro, NC 27401
Phone (336) 274-4285
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | M-1810 | GU | Yes |
| Diagnostic Radiology Physician | 2085R0202X | 00022516 | AL |
Addresses
Primary practice location
643 Chalan San Antonio Ste 109
Tamuning, GU 96913-3644
Mailing address
5251 Title Row Dr
Bradenton, FL 34210-4058
Other providers in Tamuning, GU
- Farmacia de Marianas
- John A Fegurgur
- Mary Fegurgur
- Christina Janine Mojica Felipe
- Ann Fenton
- Chris Joseph Fernandez
- Julius Santos Fernando
- Rethelje Ann Finona
- Quenie-Mei Tuliao Fisher
- James Gregory Fleming
All providers in Tamuning, GU · Diagnostic Radiology Physician in Guam
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.